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Related Experiment Video

Updated: May 20, 2026

Isolation and Quantification of Botulinum Neurotoxin From Complex Matrices Using the BoTest Matrix Assays
12:25

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Published on: March 3, 2014

Difficulties in diagnosing food-borne botulism.

Nina Forss1, Raimo Ramstad, Tom Bäcklund

  • 1Departments of Neurology, Helsinki University Central Hospital, Helsinki, Finland.

Case Reports in Neurology
|July 19, 2012
PubMed
Summary

Food-borne botulism, a muscle-paralyzing illness from Clostridium botulinum toxins, can present with sudden neurological symptoms. Two patients were misdiagnosed with stroke due to these abrupt symptoms, highlighting a diagnostic challenge.

Keywords:
BtulismBulbar palsyMisdiagnosis

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Toxicology

Background:

  • Botulism is a rare but serious paralytic illness caused by neurotoxins produced by Clostridium botulinum bacteria.
  • Food-borne botulism is typically associated with the ingestion of contaminated food products.
  • Symptoms usually manifest 12-36 hours post-ingestion, but abrupt onset can occur.

Observation:

  • Two patients presented to a neurological emergency room with symptoms mimicking acute stroke.
  • Initial clinical presentation included neurological deficits suggestive of cerebrovascular events.
  • Both patients were evaluated as candidates for intravenous thrombolysis, a stroke treatment.

Findings:

  • Diagnostic workup revealed that both patients had food-borne botulism, not stroke.
  • The neurotoxins from Clostridium botulinum were identified as the cause of the paralytic symptoms.
  • The abrupt onset of neurological symptoms in botulism can closely resemble acute stroke.

Implications:

  • This case series underscores the importance of considering botulism in the differential diagnosis of acute neurological emergencies.
  • Misdiagnosis can lead to delayed appropriate treatment for botulism and potentially unnecessary or harmful interventions like thrombolysis.
  • Increased awareness among emergency room physicians is crucial for timely and accurate diagnosis of food-borne botulism presenting as stroke mimics.