Zouari N, Choyakh F, Triki C, Mhiri C
Service d'explorations fonctionnelles, CHU H Bourguiba, Sfax, Tunisie.
Neurophysiol Clin. 1997 Jun;27(3):220-6. doi: 10.1016/s0987-7053(97)83778-1.
Botulism is a cause of neuromuscular transmission impairment. We report here an electrophysiological study of the neuromuscular junction in a patient presenting with botulism. Repetitive stimulation of a motor nerve showed a characteristic triad, indicating presynaptic block of neuromuscular transmission: the muscle action potential amplitude was low; repetitive high frequency stimulation (20 Hz) induced a more than 100% increment in the amplitude; low frequency repetitive stimulation (3 Hz) induced a more than 10% decrement in the amplitude. Progressive clinical improvement spontaneously occurred and the electrophysiological control recording that was done 1 month later was normal. Botulism toxin reduces acetylcholine quanta released in the autonomic and neuromuscular junction, causing presynaptic block. Electrophysiological recordings associated with clinical data contributed more to the diagnosis of botulism than serological analysis, which remained negative in this patients.
肉毒中毒是神经肌肉传递障碍的一个病因。我们在此报告对一名肉毒中毒患者神经肌肉接头的电生理研究。对运动神经进行重复刺激显示出特征性三联征，提示神经肌肉传递的突触前阻滞：肌肉动作电位幅度较低；高频重复刺激（20Hz）使幅度增加超过100%；低频重复刺激（3Hz）使幅度降低超过10%。临床症状逐渐自发改善，1个月后进行的电生理对照记录结果正常。肉毒毒素减少自主神经和神经肌肉接头处释放的乙酰胆碱量子，导致突触前阻滞。与临床数据相关的电生理记录对肉毒中毒的诊断比血清学分析贡献更大，该患者的血清学分析结果仍为阴性。
