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Botulism: Clinical neurophysiological findings

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Summary

Four cases of mild botulinus type B intoxication are reported with the clinical neurophysiological studies.

Electromyographically tetanic stimulation of the N. ulnaris initially led to tetanic potentiation of the muscle action potential. After an interval without any symptoms tetanic reduction became apparent between the fourth and seventh week of the illness.

The electroneurographic finding was normal during the observation period of three months.

Infrared reflex pupillographic studies revealed that the cholinergic autonomous synapses were disturbed for a period much longer than the symptoms clinically established. The speed at which the pupillographic findings returned to normal varied considerably according to the patient.

Electroencephalographic results indicated generalized groups of slow high amplitude waves in three of the four cases during the period of observation.

The pathophysiology of botulinus intoxication is discussed with a consideration of the literature and the results of this study.

Zusammenfassung

Bericht über klinisch-neurophysiologische Ergebnisse einer gutartigen Botulinus-Typ B-Intoxikation anhand von 4 Erkrankungsfällen.

Elektromyographisch fand sich bei tetanischer Reizung des N. ulnaris anfänglich eine tetanische Potenzierung des Muskelsummenaktionspotentials. Nach einem unauffälligen Intervall zeigte sich zwischen der 4. und 7. Krankheitswoche eine tetanische Reduzierung.

Der elektroneurographische Befund war über den Beobachtungszeitraum von 3 Monaten unauffällig.

Infrarot-reflex-pupillographisch konnte gezeigt werden, daß die cholinergen autonomen Synapsen weit über die klinisch feststellbaren Symptome hinaus bei unterschiedlichen Verläufen der Rückbildung gestört waren.

Elektroencephalographisch fanden sich bei 3 der 4 Patienten generalisierte Steilwellengruppen, welche sich bei 2 der Erkrankten innerhalb des Untersuchungszeitraumes zurückbildeten.

Die Pathophysiologie der Botulinusintoxikation wird unter Berücksichtigung der bisherigen Literatur und anhand der eigenen Untersuchungsergebnisse diskutiert.

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Authors and Affiliations

  1. Department of Neurology, University Hospital Hamburg-Eppendorf, Martinistr. 52, D-2000, Hamburg 20, Federal Republic of Germany

    R. Hagenah & A. Müller-Jensen

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  1. R. Hagenah
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Hagenah, R., Müller-Jensen, A. Botulism: Clinical neurophysiological findings. J. Neurol. 217, 159–171 (1978). https://doi.org/10.1007/BF00312957

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