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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.
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.
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