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December 1979

Infant Botulism-Reply

Author Affiliations

Infectious Disease Section California Department of Health Services Berkeley, CA 94704
Department of Neurology Childrens Hospital of Los Angeles Los Angeles, CA 90054
Department of Pediatrics Cedars-Sinai Medical Center Los Angeles, CA 90048

Am J Dis Child. 1979;133(12):1288. doi:10.1001/archpedi.1979.02130120080022

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In Reply.—We thank Drs Snyder and Bicknell for their letter that further documents the usefulness of EMG studies in patients with suspected infant botulism. Their observation that the muscle action potential is more enhanced at 50 cps than at 20 cps is noteworthy and should prompt the examiner especially to use the 50 cps frequency. Since EMG study of patients with infant botulism may show either the characteristic brief, small, abundant motor-unit action potentials (BSAP) pattern or enhancement of the evoked response by rapid repetitive stimulation, or both, these patterns should be sought when infant botulism is suspected. In the experience of one of us (S.A.C.), BSAP has proved the more helpful of the two patterns, but we fully concur with Drs Snyder and Bicknell that more bacteriologically proved cases of infant botulism should be studied at 50 cps. Whether one or both patterns is observed, EMG remains the

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