Botulism clinical features

Botulism. Clinical features include symmetric cranial neuropathies (i.e., drooping eyelids, weakened jaw clench, and difficulty swallowing or speaking), blurred vision or diplopia, symmetric descending weakness in a proximal to distal pattern, and respiratory dysfunction from respiratory muscle paralysis or upper airway obstruction without sensory deficits. Inhalational botulism would have a similar clinical presentation as food-borne botulism however, the gastrointestinal symptoms that accompany foodborne botulism may be absent. 

Patients with botulism classically present with difficulty seeing, speaking, and swallowing (36). Clinical features of botuhsm include ... 

We can see this clearly, for instance, in regard to the possible use of deadly botulinal toxin. It is well known that this toxin disrupts the operation of parts of the nervous system by interfering with the normal synaptic release of the key neurotransmitter chemical acetylcholine. The clinical features of botulism are very similar, regardless of how the toxin gets into the body ... 

B. Clinical Features. A biological warfare attack with botulinum toxin delivered by aerosol would be expected to cause symptoms similar in most respects to those observed with food-borne botulism. 

A botulinum antitoxin is available and can be obtained from stores held in regional centres and the HPA Centre for Infections as well as Porton Down. The decision to use antitoxin therapy will usually be made by a senior infectious diseases clinician and should rely on clinical or historical features rather than laboratory test results. Surgical debridement and antibiotic therapy may be indicated for suspected wound botulism. Respiratory failure may require endotracheal intubation and mechanical ventilation with subsequent monitoring and treatment in a critical care environment. 

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