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Isolation and Quantification of Botulinum Neurotoxin From Complex Matrices Using the BoTest Matrix Assays

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Asymmetric type F botulism with cranial nerve demyelination.

Alina Filozov¹, Jessica A Kattan, Lavanya Jitendranath

¹Division of Infectious Diseases, Middlesex Hospital, 80 S Main St, Middletown, CT 06457, USA. alina.fi lozov@midhosp.org

Emerging Infectious Diseases

|January 20, 2012

Summary

Type F botulism can cause rare, asymmetric neurologic deficits. Autopsy revealed cranial nerve demyelination, suggesting this finding may be underrecognized in botulism cases.

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Area of Science:

Neurology
Toxicology
Pathology

Background:

Botulism is a rare but serious paralytic illness caused by botulinum toxin.
Type F botulism is an uncommon subtype with distinct clinical and epidemiological features.
Neurologic deficits in botulism typically present as symmetric cranial nerve palsies.

Observation:

A case of type F botulism presented with bilateral but asymmetric neurologic deficits.
The patient exhibited clinical signs that were not uniformly distributed on both sides of the body.
Autopsy examination revealed demyelination of cranial nerves.

Findings:

Cranial nerve demyelination was identified as a potential pathological correlate of the observed asymmetric deficits.
The findings suggest that bilateral, asymmetric clinical signs, while unusual, should not exclude a diagnosis of botulism.
Autopsy findings of cranial nerve demyelination may be underrecognized in fatal cases of botulism.

Implications:

This case highlights the importance of considering botulism even with atypical clinical presentations.
Pathologists should be aware of potential cranial nerve demyelination in botulism autopsies.
Further research may clarify the frequency and significance of cranial nerve demyelination in different types of botulism.