Department of Neurology, Donostia University Hospital. Paseo Dr. Begiristain, 109, Donostia-San Sebastian, PC 20014, Spain.
Department of Neurology, Donostia University Hospital. Paseo Dr. Begiristain, 109, Donostia-San Sebastian, PC 20014, Spain.
J Clin Neurosci. 2021 Jun;88:159-162. doi: 10.1016/j.jocn.2021.03.041. Epub 2021 Apr 13.
Botulism is a life-threatening presynaptic disorder of the neuromuscular transmission produced by the neurotoxin elaborated by the botulinum neurotoxin-producing clostridia. We describe the management of a case series of 14 patients, members of 5 different families that were exposed to home-canned tuna and developed symptoms compatible with a mild clinical presentation of foodborne botulism. The electrophysiological study of the index case represented a reliable diagnostic test as it demonstrated a slight presynaptic dysfunction of the neuromuscular junction. Definite diagnosis was later confirmed by microbiological tests. Out of 14, only 3 patients presenting with a shorter period from symptom onset and with signs of multiple cranial neuropathies received botulinum antitoxin. All the patients remained stable and recovered progressively. Treatment with antitoxin may not be necessary in patients with late-presenting disease and mild and stable clinical picture.
肉毒中毒是一种由产毒梭菌产生的神经毒素引起的、危及生命的突触前神经肌肉传递障碍。我们描述了一个由 14 名患者组成的病例系列的治疗情况，这些患者属于 5 个不同的家庭，他们食用了自制的金枪鱼罐头，出现了与轻度食源性肉毒中毒临床表现相符的症状。索引病例的电生理研究是一种可靠的诊断测试，因为它显示出神经肌肉接头的轻微突触前功能障碍。随后通过微生物学测试确诊。在 14 名患者中，只有 3 名起病时间较短且有多种颅神经病变迹象的患者接受了肉毒杆菌抗毒素治疗。所有患者均保持稳定并逐渐恢复。对于发病晚、症状较轻且稳定的患者，可能不需要使用抗毒素治疗。
