Botulism

Question 1

Def

Answer 1

neuroparalysis that is caused by a potent neurotoxin produced by the spore-forming bacteria Clostridium botulinum - blocks the release of acetylcholine from presynaptic axon terminals into the synaptic cleft, irreversibly inhibiting neurotransmission.

Question 2

Types

Answer 2

foodborne botulism, infant botulism, and wound botulis

Question 3

Toxin - function

Answer 3

Botulinum toxin: protease that cleaves SNARE proteins and prevents fusion of transmitter-containing vesicles with the presynaptic membrane

Question 4

Symptoms

Answer 4

Peripheral flaccid muscle paralysis that descends caudally (typically begins in frequently used muscles)
Pupils: accommodation paralysis, mydriasis, diplopia
Pharynx: dysarthria, dysphagia
Autonomic nervous system: xerostomia
Infantile hypotonia
GI symptoms

Infants may present with infantile hypotonia
Ptosis
Floppy movements
General weakness
Poor feeding (weak sucking)

4 D’s of botulism: Dysarthria, Diplopia, Dysphagia, and Dyspnea.

Question 5

Tx

Answer 5

Antitoxin
IV human botulism immune globulin for infants

Question 6

Diff dx

Answer 6

Guillain-Barré syndrome
Myasthenia gravis
Lambert-Eaton syndrome
Tick paralysis
Myotonic dystrophy, spinal muscular atrophy