Toxic Neuromuscular Transmission Disorders

  • James F. HowardJr.
Part of the Current Clinical Neurology book series (CCNEU)


The neuromuscular junction is uniquely sensitive to the effects of multiple neurotoxins including pharmaceutical, chemical, animal, and plant sources. Unlike the brain and peripheral nerve where tissue barriers prevent excess to neuronal elements, there is no barrier to minimize the risk of these deleterious agents to the neuromuscular junction. Uniformly, with neuromuscular junction toxicity, there is a reduction in the safety factor of synaptic transmission. These may affect either the pre- or postsynaptic elements of the neuromuscular junction. Each toxin has its own specific mechanism of action that results in the defined clinical picture observed. While progress has been made in reducing the incidence of environmental neuromuscular junction toxicity that from pharmacological agents is slowly increasing and must be a concern for the clinician. further, the adaptation of biological, pharmacological, and environmental compounds to agents of war and the broadening expanse of terrorism continue to pose a threat to mankind.


Neurotoxicology Myasthenia gravis Botulism Organophosphates Biological toxins Checkpoint inhibitors Neuromuscular transmission Lambert-Eaton syndrome Synaptic transmission 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurologyThe University of North CarolinaChapel HillUSA

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