Diagnosis and treatment of botulism

JIN Lingjing; PAN Lizhen; WANG Lin; WAN Xinhua

doi:10.12022/jnnr.2016-0054

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Journal of Neurology and Neurorehabilitation ›› 2016, Vol. 12 ›› Issue (4) : 173-180. DOI: 10.12022/jnnr.2016-0054

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Diagnosis and treatment of botulism

JIN Lingjing¹, PAN Lizhen¹, WANG Lin², WAN Xinhua²

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Abstract

Botulinum neurotoxin (BoNT) produced by Clostridium botulinum selectively cleaves soluble N-ethyl-maleimide-sensitive factor attachment protein receptor (SNARE) complex protein and thus inhibits neurotransmitter release and causes chemodenervation. BoNT has been used in many fields such as clinical diagnosis and treatment and cosmetic surgery. Botulism is a neuroparalytic disease caused by over-dose of BoNT. Iatrogenic botulism is most commonly observed after injection of neurotoxin with poor quality or not following usage rules. The symptoms of botulism commonly present as acute symmetrical descending flaccid paralysis. In some severe cases, respiratory failure may happen, which can even cause death. Once botulism happens, early administration of antitoxin is the most effective therapy, thus early diagnosis is essential. The diagnosis of botulism is mainly based on medical history and physical examination because toxin detection and Clostridium botulinum culture are both time-consuming. Nerve electrophysiological tests may be helpful in differential diagnosis. This paper reviews the researches on botulism, which may provide a basis for the diagnosis and treatment of botulism.

Key words

Botulinum toxins / Neurotoxins / Poisoning / Diagnosis / Therapy

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JIN Lingjing, PAN Lizhen, WANG Lin, WAN Xinhua. Diagnosis and treatment of botulism[J]. Journal of Neurology and Neurorehabilitation. 2016, 12(4): 173-180 https://doi.org/10.12022/jnnr.2016-0054

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Funding

Youth Foundation of National Natural Science Foundation of China (No. 81500970); General Project of Shanghai Municipal Commission of Health and Family Planning (No. 201440535)