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Neurophysiological assessment in the diagnosis of botulism: Usefulness of single‐fiber EMG
Author(s) -
Padua Luca,
Aprile Irene,
Monaco Mauro Lo,
Fenicia Lucia,
Anniballi Fabrizio,
Pauri Flavia,
Tonali Pietro
Publication year - 1999
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/(sici)1097-4598(199910)22:10<1388::aid-mus8>3.0.co;2-3
Subject(s) - botulism , neuromuscular transmission , medicine , neurophysiology , electromyography , repetitive nerve stimulation , clinical neurophysiology , compound muscle action potential , anesthesia , neuromuscular junction , respiratory failure , physical medicine and rehabilitation , neuroscience , electroencephalography , electrophysiology , psychology , genetics , psychiatry , biology
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. © 1999 John Wiley & Sons, Inc. Muscle Nerve 22: 1388–1392, 1999