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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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References

  1. Baykuschew, S., Hopf, H. C.: Amplitude und Dauer des Muskelantwortpotentials im Beginn einer Reizserie. Z. EEG-EMG 1, 115 (1970)

    Google Scholar 

  2. Brooks, V. B.: Motor nerve filament block produced by botulinum toxin. Science 117, 334 (1953)

    Google Scholar 

  3. Brooks, V. B.: An intracellular study of the action of repetitiv nerve volleys and of botulinum toxin on miniature endplate potentials. J. Physiol. 134, 264–277 (1956)

    Google Scholar 

  4. Buhl, H., Hertel, V.: Botulismus, Bericht über 9 Fälle. Med. Welt 22, 2033–2035 (1971)

    Google Scholar 

  5. Carpenter, G. G.: Motor responses of the urinary bladder and skeletal muscle in botulinum intoxicated rats. J. Physiol. 188, 1–11 (1967)

    Google Scholar 

  6. Cherington, M.: Botulism. Arch. Neurol. 30, 432–437 (1974)

    Google Scholar 

  7. Cherington, M., Ryan, D. W.: Treatment of botulism with guanidine. J. Med. 282, 195–197 (1970)

    Google Scholar 

  8. Chukhrova, V. A.: Changes of the brain electrical activity in patients with botulism. Z. Nevropat. Psichiat. 70, 52–55 (1970)

    Google Scholar 

  9. Desmedt, J. E.: Méthodes d'étude de la fonction neuromusculaire chez l'homme. Acta neurol. belg. 58, 977–1017 (1958)

    Google Scholar 

  10. Donadio, J. A., Gangarosa, E. J., Faich, G. A.: Diagnosis and treatment of botulism. J. infect. Dis. 124, 108–112 (1971)

    Google Scholar 

  11. Duchen, L. W.: Effects of botulinum toxin on the distribution of succinate dehydrogenase and phosphorylase in fast and slow skeletal muscles of the mouse. J. Neurol., Neurosurch., Psychiatr. 33, 580–585 (1970)

    Google Scholar 

  12. Elmquist, D.: Neuromuscular transmission defects. New developments in electromyography and clinical neurophysiology, ed. J. E. Desmedt, Vol. 1, pp. 229–240. Basel: Karger 1973

    Google Scholar 

  13. Gangarosa, E. J., Donadio, J. A., Armstrong, R. W., Meyer, K. F., Brachmann, P. S., Dowell, V. R.: Botulism in the United States 1899–1969. Amer. J. Epidem. 93, 93 (1971)

    Google Scholar 

  14. Graebner, R. W., Cleeland, C. S.: Neurological and neuropsychological effects of botulinum toxin. Dis. nerv. Syst. 32, 702–706 (1971)

    Google Scholar 

  15. Gutman, L., Oguchi, K., Chou, S. M.: Neuromuscular junction in human botulism. Electromyography 13, 113 (1973)

    Google Scholar 

  16. Habermann, E., Heller, I.: Direct evidence for the specific fixation of clostridium botulinum A neurotoxin to brain matter. Naunyn-Schmiedeberg's Arch. Pharmacol. 287, 97–106 (1975)

    Google Scholar 

  17. Hagenah, R., Müller-Jensen, A.: Pupillographische und elektromyographische Befunde bei Botulismus. Electroenceph. clin. Neurophysiol. 39, 532 (1975)

    Google Scholar 

  18. Hagenah, R., Benecke, R., Wiegand, H.: Effects of neurotoxin of Clostridium botulinum A on a central cholinergic synapse. Naunyn Schmiedeberg's Arch. Pharmacol. 299, 267–272 (1977)

    Google Scholar 

  19. Hopf, H. C., Baykuschew, S.: Dauer und Amplitude des Muskelantwortpotentials in Relation zur Stimulationsfrequenz bei repetitiver indirekter Reizung. Z. EEG-EMG 5, 225–230 (1974)

    Google Scholar 

  20. Jacobi, H. M., Struppler, A.: How to evaluate variations in muscle action potentials following repeated nerve stimulation. Electroenceph. clin. Neurophysiol. 25, 402 (1968)

    Google Scholar 

  21. Jenzer, G., Mumenthaler, M., Ludin, H. P., Robert, F.: Botulismus Typ B. Schweizer med. Wochenschr. 104, 685–693 (1974)

    Google Scholar 

  22. Kauf, C., Lorent, J. P., Mosimann, J., Schlatter, I., Somaini, B., Velhart, J.: Botulismusepidemie vom Type B. Schweiz. med. Wschr. 104, 677–685 (1974)

    Google Scholar 

  23. Koenig, M. G., Drutz, D. J., Mushlin, A. I., Schaffner, W., Rogers, D. E.: Type B botulism in man. Amer. J. Med. 42, 208–219 (1967)

    Google Scholar 

  24. Lambert, E. H.: Defects of neuromuscular transmission in syndromes other than myasthenia gravis. Ann. N.Y. Acad. Sci. 135, 367–384 (1966)

    Google Scholar 

  25. Mellanby, J., Thompson, P. A., Hampden, N.: On the similarity of tetanus and botulinum toxins. Naunyn Schmiedeberg's Arch. Pharmacol. 276, 303–310 (1973)

    Google Scholar 

  26. Müller-Jensen, A.: Anwendungsmöglichkeiten der Infrarot-Reflexpupillographie in der Neurologie. Nervenarzt 46, 281–284 (1975)

    Google Scholar 

  27. Müller-Jensen, A., Bushart, W., Hagenah, R.: Hirnelektrische Verläufe nach Botulinusintoxikation. Electroenceph. clin. Neurophysiol. 39, 533 (1975)

    Google Scholar 

  28. Petersen, I., Broman, A. M.: Electromyographic findings in a case of botulism. Nordisk Med. 23, 259–261 (1961)

    Google Scholar 

  29. Polley, E. H., Vick, J. A., Chiuchta, H. P., Fischetti, D. A., Macchitelli, F. J., Montanarelli, N.: Botulinum toxin type A. Effects on central nervous system. Science 147, 1036–1037 (1965)

    Google Scholar 

  30. Richert, S., Hagenah, R., Müller-Jensen, A.: Leichte Verlaufsform einer Botulinusintoxikation. DMW 46, 2394–2397 (1975)

    Google Scholar 

  31. Ricker, K., Döll, W.: Guanidinbehandlung des Botulismus. Z. Neurol. 198, 332–341 (1970)

    Google Scholar 

  32. Sandmann, F.: Familiäre Botulismusendemie. Tierärztl. Praxis 1, 237–239 (1973)

    Google Scholar 

  33. Simpson, L. L., de Balbian Verster, F., Tapp, J. T.: Electrophysiological manifestations of experimental botulinal intoxication: Depression of cortical EEG. Exp. Neurol. 19, 199–211 (1973)

    Google Scholar 

  34. Simpson, L. L., Boroff, D. A., Fleck, U.: Examination of the possible pathophysiology of the central nervous system during botulinal poisoning. Exp. Neurol. 22, 85–95 (1968)

    Google Scholar 

  35. Spitzer, N.: Miniature end-plate potentials at mammalian neuromuscular junctions poisoned by botulinum toxin. Nature, New Biol. 237, 26–27 (1972)

    Google Scholar 

  36. Struppler, A.: Die Erkrankung der motorischen Endplatte, einschließlich der Myasthenia gravis. Wiener klin. Wschr. 79, 620–621 (1967)

    Google Scholar 

  37. Tonge, D. A.: Chronic effects of botulinum toxin on neuromuscular transmission and sensitivity to acetylcholine in slow and fast skeletal muscle of the mouse. J. Physiol. 241, 127–139 (1974)

    Google Scholar 

  38. Tyler, H. R.: Botulismus toxin: Effects on the central nervous system of man. Science 139, 847–848 (1963)

    Google Scholar 

  39. Wiegand, H., Wellhöner, H. H.: Type A botulinum toxin in cats. Neural ascent and action on spinal cord reflexes. Naunyn Schmiedeberg's Arch. Pharmacol. 282, R. 106 (1974)

    Google Scholar 

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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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