Iatrogenic Botulism Following Botulinum Toxin Injection in Palmar Hyperhidrosis: A Case Report

Botulinum toxin (BT) injection is commonly used for the treatment of hyperhidrosis, with palmar hy-perhidrosis being a frequent indication. Although generally safe, rare cases of botulism following BT administration have been reported. It is a potentially serious complication of inappropriate admin-istration of high doses with unlicensed product application; therefore, prompt recognition and appro-priate management are crucial for satisfying outcomes. We present the case of a 28-year-old woman who presented with progressing clinical condition mimicking myasthenia gravis (MG). Diagnosis was confirmed through clinical examination, laboratory testing, neuroimaging, and electrophysiological findings. The aim of this case report is to highlight the importance of considering iatrogenic botulism in patients presenting with neurological symptoms, particularly weakness, ptosis, dysphagia, and dysarthria, and to underscore the utility of a MG treatment protocol in managing cases of iatrogenic botulism presenting late.