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Botulism
Author(s) -
Maselli Ricardo A.,
Bakshi Nandini
Publication year - 2000
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 - 10.1002/1097-4598(200007)23:7<1137::aid-mus21>3.0.co;2-7
Subject(s) - botulism , denervation , medicine , motor unit , compound muscle action potential , differential diagnosis , electromyography , botulinum toxin , anesthesia , electrophysiology , physical medicine and rehabilitation , anatomy , pathology , biology , genetics
Early diagnosis of botulism is essential for effective treatment. Electrophysiologic testing can be of major help to establish a prompt diagnosis, but the classic electrodiagnostic features of botulism are often elusive. Decrement or increment of compound muscle action potential (CMAP) amplitudes to slow or fast rates of nerve stimulation are often unimpressive or totally absent. Reduction of CMAP amplitudes, denervation activity, or myopathic‐like motor unit potentials in affected muscles are found more frequently but they are less specific. In general, the electrophysiologic findings taken together suggest involvement of the motor nerve terminal, which should raise the possibility of botulism. The case reported here illustrates a common clinical presentation of botulism. This study emphasizes realistic expectations of the electrodiagnostic testing, the differential diagnosis, and the potential pitfalls often encountered in the interpretation of the electrophysiologic data. © 2000 American Association of Electrodiagnostic Medicine. Muscle Nerve 23: 1137–1144, 2000