TY - JOUR
T1 - Neurophysiological assessment in the diagnosis of botulism
T2 - Usefulness of single-fiber EMG
AU - Padua, Luca
AU - Aprile, Irene
AU - Lo Monaco, Mauro
AU - Fenicia, Lucia
AU - Anniballi, Fabrizio
AU - Pauri, Flavia
AU - Tonali, Pietro
PY - 1999/10
Y1 - 1999/10
N2 - 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.
AB - 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.
KW - Botulism
KW - Electrodiagnosis
KW - Neuromuscular transmission
KW - Single-fiber electromyography
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U2 - 10.1002/(SICI)1097-4598(199910)22:10<1388::AID-MUS8>3.0.CO;2-3
DO - 10.1002/(SICI)1097-4598(199910)22:10<1388::AID-MUS8>3.0.CO;2-3
M3 - Article
C2 - 10487905
AN - SCOPUS:0032873260
VL - 22
SP - 1388
EP - 1392
JO - Muscle and Nerve
JF - Muscle and Nerve
SN - 0148-639X
IS - 10
ER -