Serum positive botulism with neuropathic features

Chang, Victor H.; Robinson, Lawrence R.

doi:10.1016/s0003-9993(00)90232-6

Cited by 10 publications

(6 citation statements)

References 11 publications

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“…8 Our case shares many similarities to a previously reported case, 9 in which a bioassay for botulism type B was positive in the context of clinical features and electrodiagnostic evidence supportive of MFS. The authors postulated that botulinum antitoxin may protect mice from toxic effects of serum from patients with MFS, the possibility of which is substantiated by the present patient.…”

Section: Discussionsupporting

confidence: 79%

False-Positive Serum Botulism Bioassay in Miller–Fisher Syndrome

Zeylikman

Shah

et al. 2015

Journal of Clinical Neuromuscular Disease

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We describe a patient with acute progressive weakness and areflexia. Both botulism and Miller-Fisher variant of Guillain-Barré syndrome were initial diagnostic considerations, and she was treated with intravenous immunoglobulin and botulinum antitoxin. A mouse bioassay was positive for botulinum toxin A, although her clinical course, electrodiagnostic studies, and cerebrospinal fluid findings supported Miller-Fisher syndrome. This patient's atypical features offer points of discussion regarding the evaluation of patients with acute neuromuscular weakness and emphasize the limitations of the botulism bioassay.

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Section: Discussionsupporting

confidence: 79%

False-Positive Serum Botulism Bioassay in Miller–Fisher Syndrome

Zeylikman

Shah

et al. 2015

Journal of Clinical Neuromuscular Disease

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“…This is particularly challenging because the observed paralytic symptoms are not specific to botulism but are also associated with several other syndromes [2]. The misdiagnosis of botulism may lead to prolonged hospitalization and dependence on supportive ventilation, whereas patients who are mistakenly suspected to have botulism may receive unnecessary antitoxin [11], which carries the risk of anaphylaxis and serum sickness.…”

Section: Discussionmentioning

confidence: 99%

Early, Real-Time Medical Diagnosis of Botulism by Endopeptidase-Mass Spectrometry

Rosen¹,

Feldberg²,

Gura³

et al. 2015

Clin Infect Dis.

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“…Epidemiologic studies have indicated previous infection with certain bacteria, eg, Campylobacter jejuni and viruses, eg, cytomegalovirus and Epstein–Barr viruses 11,12. The syndrome has several pathologic subtypes, the most common being multifocal demyelinating polyneuropathy.…”

Section: Discussionmentioning

confidence: 99%

Role of anti-GQ1B antibody in differential diagnosis of acute ophthalmoparesis

Boylu¹

2010

NDT

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Miller Fisher syndrome (MFS) is a triad of total external ophthalmoplegia, ataxia, and areflexia, while botulism has the usual clinical presentation of involvement of cranial muscles and palsies with blurred vision, diplopia, ptosis, dilated pupils, and facial paralysis, caused by a bacterial neurotoxin which attacks proteins involved in presynaptic vesicle release. In this report, we needed to make the differential diagnosis between MFS and botulism in a patient who presented with acute ophthalmoparesis and a history of diarrhea three days before, which started two days after consuming tinned food. Routine laboratory, neurophysiologic, and imaging investigations were normal. A clinical diagnosis of Miller Fisher syndrome was reached by anti-ganglioside GQ1B and GM1 Ig G and M antibody investigations which proved positive. The patient was treated with intravenous immunoglobulin two weeks after (in the late period) the symptoms started and he has recovered completely. Systemic autoimmune diseases should be considered in patients with bilateral ophthalmoparesis. As in the present patient, the evaluation of specific antibodies helps in the diagnosis and thus early effective treatment is possible.

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Serum positive botulism with neuropathic features

Cited by 10 publications

References 11 publications

False-Positive Serum Botulism Bioassay in Miller–Fisher Syndrome

False-Positive Serum Botulism Bioassay in Miller–Fisher Syndrome

Early, Real-Time Medical Diagnosis of Botulism by Endopeptidase-Mass Spectrometry

Role of anti-GQ1B antibody in differential diagnosis of acute ophthalmoparesis

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