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Clinical Features of botulism
What are the clinical characteristics of botulism?
Two to forty-eight hours after ingesting improperly prepared or preserved foods contaminated with Clostridium botulinum , ocular and bulbar muscle paralysis begins, with difficulty in convergence of the eyes, diplopia, ptosis, weakness of the jaw muscles, dysphagia, and dysarthria. Nausea, vomiting, and diarrhea may precede these symptoms.
Constipation, urinary retention, and nonreactive dilation of the pupils may occur because of autonomic dysfunction.
Respiratory failure and total limb paralysis may ensue without sensory loss or mental status changes.
Infantile botulism may result in poor sucking and difficulty with feeding, weak cry, loss of head control, and bilateral ptosis, with subsequent generalized flaccid paralysis.
The course depends on the amount of toxin absorbed, ranging from death within 4 to 8 days without respiratory support to mild symptoms with complete recovery.
Sources
Weimer MG, Wong J: Lambert-Eaton myasthenic syndrome. Curr Treat Options Neurol 11:77-84, 2009.