Sheth R D, Lotz B P, Hecox K E, Waclawik A J
Department of Neurology, University of Wisconsin, Madison 53792-5132, USA.
J Child Neurol. 1999 Mar;14(3):156-8. doi: 10.1177/088307389901400304.
Botulism in infants, unless recognized early, is associated with high mortality and morbidity. The diagnosis is suspected when infants present with sudden onset of weakness, respiratory failure, and constipation and is confirmed by demonstration of botulinum toxin in stool several weeks later. Electrodiagnosis allows quick and reliable confirmation of botulism. Low-amplitude compound muscle action potentials, tetanic or post-tetanic facilitation, and the absence of post-tetanic exhaustion support the diagnosis. Two infants with confirmed botulism did not exhibit the characteristic electrodiagnostic features, demonstrating the pitfalls in electrodiagnosis of infantile botulism.
婴儿肉毒中毒若不及早识别，会导致高死亡率和高发病率。当婴儿突然出现肌无力、呼吸衰竭和便秘时，应怀疑该病，数周后粪便中检出肉毒杆菌毒素可确诊。电诊断可快速可靠地确诊肉毒中毒。复合肌肉动作电位波幅降低、强直或强直后易化以及无强直后疲劳支持该诊断。两名确诊为肉毒中毒的婴儿未表现出典型的电诊断特征，这表明婴儿肉毒中毒的电诊断存在陷阱。
