Clinical and electrodiagnostic follow up of a case of food borne botulism

Abstract

In the following case report, we describe the follow up of electrodiagnostic studies together with the clinical pattern in a 40 year old woman diagnosed as botulinum intoxication caused by home-made canned green beans. She had dyplopia, blurred vision, weakness and paresthesias in all four extremities, difficulty of swallowing and breathing and bifascial paralysis. Repetetive nerve stimulation and blink reflex studies were performed during the follow up of the case. Serologic tests couldn't be performed. Antitoxin therapy was initialised immediately, recovery of symptoms began in about a month's time and she was symptom free in three months. Her electrodiagnostic tests also improved and were found to be normal. We believe that diagnosis of botulinum intoxication on clinical grounds is far more important than it is supposed because electrodiagnosis may not be always very typical and serologic tests may not be available. Therefore we believe that initialising the antitoxin therapy is life saving and should be performed immediately, even if the diagnosis is mostly on clinical grounds.