Cherington Michael
Emeritus Professor of Clinical Neurology, University of Colorado School of Medicine, and Lightning Data Center, St. Anthony Hospital, Denver, Colorado 80204, USA.
Semin Neurol. 2004 Jun;24(2):155-63. doi: 10.1055/s-2004-830901.
Botulism is both an old and an emerging disease. Over 100 years ago, the classic food-borne type was found to be caused by ingesting contaminated food containing the toxin produced by a bacteria. In the first half of the 20th century a second form, wound botulism, was discovered. Three additional forms (infant, hidden, and inadvertent) were first described in the last quarter of the 20th century. Our understanding of how botulinum toxin blocks the release of acetylcholine at the neuromuscular junction has been clarified in the past 10 years. In the past 20 years, we have witnessed one of the strangest of all ironies in the history of medicine. The very lethal botulinum toxin is now being used as a treatment in an expanding list of disorders. Research is advancing in several directions. These new avenues include improved methods of preventing and treating botulism and additional novel uses of botulinum toxin as a therapeutic agent. In this article, the five clinical forms of botulism, the actions of botulinum toxins, electrodiagnostic methods, treatments, and possible future directions are discussed.
肉毒中毒既是一种古老的疾病，也是一种新出现的疾病。100多年前，人们发现经典的食源性肉毒中毒是由于摄入含有细菌产生的毒素的受污染食物所致。20世纪上半叶，发现了第二种形式的肉毒中毒，即创伤性肉毒中毒。另外三种形式（婴儿型、隐匿型和意外型）在20世纪最后25年首次被描述。在过去10年里，我们对肉毒杆菌毒素如何阻断神经肌肉接头处乙酰胆碱释放的认识已经明晰。在过去20年里，我们见证了医学史上最奇怪的讽刺之一。极具致命性的肉毒杆菌毒素现在正被用于越来越多疾病的治疗。研究正朝着几个方向推进。这些新途径包括预防和治疗肉毒中毒的改进方法，以及肉毒杆菌毒素作为治疗剂的其他新用途。本文讨论了肉毒中毒的五种临床形式、肉毒杆菌毒素的作用、电诊断方法、治疗方法以及未来可能的发展方向。
