Huang Xuanyu, Hu Zhiping, Xiao Han, Huang Yan
Department of Neurology, The Second Xiangya Hospital of Central South University, Changsha, China.
NHC Key Laboratory of Birth Defect for Research and Prevention (Hunan Provincial Maternal and Child Health Care Hospital), Changsha, China.
Front Neurol. 2025 Apr 7;16:1574807. doi: 10.3389/fneur.2025.1574807. eCollection 2025.
To examine the clinical presentations, and therapeutic principles of botulism, with the goal of improving physicians' understanding of the condition and refining treatment strategies.
A retrospective analysis was carried out on the clinical data of 8 patients with botulism, encompassing age, gender, etiology, delay diagnosis time, course of disease, clinical manifestations, auxiliary examinations, and treatment.
Among the 8 cases, 5 were female and 3 male, with the age ranging from 14 to 60 years. 5 cases were of iatrogenic poisoning, and 3 were of foodborne poisoning. Besides the classical clinical manifestations, some patients had atypical symptoms like intestinal obstruction, unilateral involvement, and consciousness disorder. Among the 8 cases, 6 had abnormal electrophysiological examination results. 6 patients had a delayed diagnosis of over 7 days, with disease course from 7 to 115 days, and 7 received treatment. All patients received symptomatic and supportive treatment. Moreover, 4 received invasive respiratory support, 3 received intravenous immunoglobulin injection, 1 received plasma exchange therapy, and 1 received antitoxin therapy. All patients were discharged with normal cranial nerve function, gastrointestinal function, muscle strength, and tone.
Patients with botulism may exhibit atypical clinical symptoms, necessitating heightened vigilance from physicians. Neurophysiological studies are integral to the diagnostic process. Furthermore, symptomatic supportive treatment is essential for patients whose diagnosis has been delayed beyond 7 days. In conclusion, a comprehensive understanding of the clinical features, differential diagnostic criteria, and therapeutic options for botulism is essential for reducing disease duration, optimizing patient outcomes, and enhancing treatment efficacy.
探讨肉毒中毒的临床表现及治疗原则，以提高医生对该病的认识并优化治疗策略。
对8例肉毒中毒患者的临床资料进行回顾性分析，包括年龄、性别、病因、诊断延迟时间、病程、临床表现、辅助检查及治疗情况。
8例患者中，女性5例，男性3例，年龄14～60岁。5例为医源性中毒，3例为食源性中毒。除典型临床表现外，部分患者有肠梗阻、单侧受累及意识障碍等非典型症状。8例中6例电生理检查结果异常。6例患者诊断延迟超过7天，病程7～115天，7例接受治疗。所有患者均接受对症及支持治疗。此外，4例接受有创呼吸支持，3例接受静脉注射免疫球蛋白，1例接受血浆置换治疗，1例接受抗毒素治疗。所有患者出院时脑神经功能、胃肠功能、肌力及肌张力均正常。
肉毒中毒患者可能出现非典型临床症状，医生需提高警惕。神经生理学检查是诊断过程的重要组成部分。此外，对于诊断延迟超过7天的患者，对症支持治疗至关重要。总之，全面了解肉毒中毒的临床特征、鉴别诊断标准及治疗选择对于缩短病程、优化患者预后及提高治疗效果至关重要。
