Diagnostic difficulties in patients with adul botulism type a

Although the ekcuodiagnostic abnormalities in botulism have bean well characterized, the expected abnormalities, such as facilitation of compound muscle anion potential amplitudes after sustained activation or with repetitive stimulation at fast tales, may not always be present especially early m the disease. This may lead to etectrodtagnosttc difficulties and sometimes a delay in establishing a diagnosis. We describe four serologically proven cases of type A botulism in adults that illustrate the variability in ekctrodiagnostic findings in this disease.