Infant botulism intoxication and autonomic nervous system dysfunction

Patural, Hugues; Goffaux, Philippe; Paricio, Caroline; Émériaud, Guillaume; Teyssier, G; Barthélémy, Jean‐Claude; Pichot, Vincent; Roche, Frédéric

doi:10.1016/j.anaerobe.2009.03.004

Cited by 16 publications

(4 citation statements)

References 13 publications

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“…In small case series, dysautonomia, measured by recording HRV, has been detected during infantile botulism, and persisted for many weeks beyond the observable physical recovery of the disease. The authors underlined the importance of close cardiopulmonary monitoring following apparent functional recovery from the botulism neurotoxin, to avoid possible complications related to autonomic dysfunction, such as syncope, arising from ventricular arrhythmia, or sudden death 132–133 …”

Section: Ans Hrv and Intensive Carementioning

confidence: 99%

Heart rate variability: a diagnostic and prognostic tool in anesthesia and intensive care

Mazzeo¹,

Monaca²,

Leo

et al. 2011

Acta Anaesthesiologica Scandinavica

139

118

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The autonomic nervous system (ANS) plays an important role in the human response to various internal and external stimuli, which can modify homeostasis, and exerts a tight control on essential functions such as circulation, respiration, thermoregulation and hormonal secretion. ANS dysfunction may complicate the perioperative course in the surgical patient undergoing anesthesia, increasing morbidity and mortality, and, therefore, it should be considered as an additional risk factor during pre-operative evaluation. Furthermore, ANS dysfunction may complicate the clinical course of critically ill patients admitted to intensive care units, in the case of trauma, sepsis, neurologic disorders and cardiovascular diseases, and its occurrence adversely affects the outcome. In the care of these patients, the assessment of autonomic function may provide useful information concerning pathophysiology, risk stratification, early prognosis prediction and treatment strategies. Given the role of ANS in the maintenance of systemic homeostasis, anesthesiologists and intensivists should recognize as critical the evaluation of ANS function. Measurement of heart rate variability (HRV) is an easily accessible window into autonomic activity. It is a low-cost, non-invasive and simple to perform method reflecting the balance of the ANS regulation of the heart rate and offers the opportunity to detect the presence of autonomic neuropathy complicating several illnesses. The present review provides anesthesiologists and intensivists with a comprehensive summary of the possible clinical implications of HRV measurements, suggesting that autonomic dysfunction testing could potentially represent a diagnostic and prognostic tool in the care of patients both in the perioperative setting as well as in the critical care arena.

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Section: Ans Hrv and Intensive Carementioning

confidence: 99%

Heart rate variability: a diagnostic and prognostic tool in anesthesia and intensive care

Mazzeo¹,

Monaca²,

Leo

et al. 2011

Acta Anaesthesiologica Scandinavica

139

118

View full text Add to dashboard Cite

show abstract

“…At the time of this report, approximately 15 mo after discharge, she continued to exhibit mild constipation and weakness of her oral muscles during feedings. Dysautonomia persisting beyond observable clinical recovery has been described in another recent case report as well [17].…”

Section: Discussionmentioning

confidence: 82%

Infant botulism manifesting in an exclusively breast-fed patient: A case report

Harrison

Liggin

2015

J Pediatr Neurol

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“…To our knowledge, this is the first case of Takotsubo-like myocardial dysfunction in a patient with botulism; however, we believe that this condition has likely also been observed previously in studies on autonomic dysfunction due to botulism ( 3 ). Autonomic failure due to botulism had been considered to account for some cases of sudden infant death syndrome ( 4 ) as well as arrhythmias and electrocardiographic changes in adults ( 5 ). In our case, we hypothesized that the suppression of acetylcholine release in the peripheral ganglia and postganglionic parasympathetic nerves by the botulinum toxins strengthened the postganglionic sympathetic nerve effects, which has norepinephrine as the primary transmitter.…”

Section: Discussionmentioning

confidence: 99%

Takotsubo-like Myocardial Dysfunction in a Patient with Botulism

et al. 2017

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Botulinum toxin A (BTXA) can disrupt the neuromuscular and autonomic functions. We herein report a case of autonomic system dysfunction that manifested as Takotsubo-like myocardial dysfunction in a patient with botulism. Takotsubo syndrome results in acute cardiac insufficiency, another fatal complication of botulism in addition to respiratory muscle paralysis, particularly in patients with cardiovascular disease.

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Infant botulism intoxication and autonomic nervous system dysfunction

Cited by 16 publications

References 13 publications

Heart rate variability: a diagnostic and prognostic tool in anesthesia and intensive care

Heart rate variability: a diagnostic and prognostic tool in anesthesia and intensive care

Infant botulism manifesting in an exclusively breast-fed patient: A case report

Takotsubo-like Myocardial Dysfunction in a Patient with Botulism

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