A patient with probable wound botulism survived on assisted ventilation without guanidine or antitoxin treatment and recovered completely. Diagnosis was aided by electrophysiologic technique indicating a defect in the neuromuscular junction similar to the Eaton-Lambert syndrome. Improvement of the abnormal electrical signs paralleled clinical improvement. A transient defect in staircase formation and dissociation of posttetanic electrical potential and mechanical force suggested a muscular disorder in addition to the known effects of botulism on the terminal neural twigs.
de Jesus PV, Slater R, Spitz LK, Penn AS. Neuromuscular Physiology of Wound Botulism. Arch Neurol. 1973;29(6):425–431. doi:10.1001/archneur.1973.00490300087012
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