Clinically compatible signs and symptoms included muscle weakness, difficulty swallowing, blurred vision, drooping eyelids, slurred speech, difficulty breathing, loss of facial expression, or descending paralysis. All patients were treated with heptavalent botulism antitoxin (BAT).
Botulism, a nationally notifiable condition, is a rare but serious illness of descending paralysis most commonly caused by the neurotoxin produced by the anaerobic, gram-positive bacteria Clostridium botulinum; wound botulism in particular results from germination of C.
All cases presented with bulbar palsy, 9 cases associated with bilateral VII nerve palsy, 4 cases developed descending paralysis. Out of the 4 patients with descending paralysis, 2 showed demyelinating neuropathy and 2 showed drop in the CMAP amplitudes.
Of 45 cases, 11 cases came for follow up, out of which 10 patients with bulbar palsy, improved within 4-6 months, 1 case with descending paralysis also improved after I year.
Over a period of 5 hours, descending paralysis
Progression to descending paralysis
was typical of botulism (2,3).
Botulism, in contrast, causes a descending paralysis
with preserved mental status, Dr.
Her symptoms began with vomiting; then she exhibited signs of descending paralysis
beginning with blurred vision, difficulty speaking, facial paralysis, and eventually, difficulty breathing.
On June 29, both patients had onset of illness that progressed to include cranial nerve palsies and symmetric, descending paralysis
typical of botulism.
However, some specific signs and symptoms (e.g., descending paralysis
) may be detectable early on and are virtually diagnostic (Figure).
On September 25, officials at the Florida Department of Health, the Hillsborough County Health Department, and CDC were notified that a patient had been hospitalized in Tampa, Florida, on September 16, with respiratory failure and descending paralysis
. On September 28, botulinum toxin type A was identified in the patient's serum.
Patients typically develop cranial nerve palsies followed by descending paralysis
that can lead to respiratory failure and death.