Neurophysiological assessment in the diagnosis of botulism: Usefulness of single-fiber EMG

Luca Padua, Irene Aprile, Mauro Lo Monaco, Lucia Fenicia, Fabrizio Anniballi, Flavia Pauri, Pietro Tonali

Research output: Contribution to journalArticlepeer-review


We report the clinical, serological, and neurophysiological findings in seven patients with foodborne botulism caused by ingestion of black olives in water. The clinical picture was characterized by mild symptoms with a long latency of onset and by involvement of cranial and upper limb muscles; only one patient, a child, developed respiratory failure. Spores of Clostridium botulinum were found in stools in some but not all cases. Conventional neurophysiological tests had low sensitivity; abnormal findings were present only in the patient with severe clinical involvement, in whom compound muscle action potentials (CMAPs) appeared reduced. Repetitive nerve stimulation at a high rate showed pseudofacilitation and not true posttetanic facilitation, but single-fiber electromyography (SFEMG) showed abnormalities of neuromuscular transmission in every case. Neurophysiological evaluation, particularly SFEMG, is important because it allows rapid identification of abnormal neuromuscular transmission while bioassay studies are in progress.

Original languageEnglish
Pages (from-to)1388-1392
Number of pages5
JournalMuscle and Nerve
Issue number10
Publication statusPublished - Oct 1999


  • Botulism
  • Electrodiagnosis
  • Neuromuscular transmission
  • Single-fiber electromyography

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)


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