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Autonomic dysfunction in botulism B: a clinical report.

G Jenzer, M Mumenthaler, H P Ludin

    Neurology
    |February 1, 1975
    PubMed
    Summary
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    This study presents nine cases of botulism B affecting autonomic nerves, causing persistent dry mouth and blurred vision. Late-stage antitoxin is not advised, but guanidine may help manage symptoms.

    Area of Science:

    • Neurology
    • Toxicology
    • Autonomic Nervous System Disorders

    Background:

    • Botulism B can manifest with significant autonomic nervous system involvement.
    • Cholinergic autonomic dysfunction presents unique diagnostic and therapeutic challenges.

    Purpose of the Study:

    • To describe nine cases of botulism B with predominant autonomic cholinergic effects.
    • To evaluate the efficacy of late-stage antitoxin and guanidine treatment.
    • To question the validity of
    • acute autonomic neuropathy
    • as a distinct clinical entity.

    Main Methods:

    • Clinical case series presentation.
    • Detailed symptom documentation including visual and oral dryness.
    • Electromyographic studies to assess neuromuscular function.

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    Main Results:

    • All patients exhibited blurred vision and dry mouth.
    • Impaired salivary and lacrimal secretion persisted for months.
    • Electromyography showed no neuromuscular involvement in the absence of overt clinical signs.

    Conclusions:

    • Botulism B can present with prolonged cholinergic autonomic dysfunction.
    • Late-stage antitoxin administration is not recommended; guanidine may be beneficial.
    • The concept of "acute autonomic neuropathy" requires further scrutiny in light of these findings.