Botulism

Signs and Symptoms

  • Flaccid Paralysis
  • Droopy Eyelids
  • Dry Mouth and Throat
  • Difficulty Talking and Swallowing
  • Blurred and Double Vision
  • Difficult Breathing
  • Asphyxia
The autonomic features of botulism are typical anticholinergic signs and symptoms: dry mouth, ileus, constipation, and urinary retention. Nausea and vomiting can occur. Dilated pupils occur in approximately 50 percent of cases. The motor complications of botulism feature a descending paralysis leading to blurred vision and, eventually, respiratory failure may occur. Symptoms usually begin 12 to 36 hours following intoxication; time can vary according to the amount of toxin absorbed and could be reduced to hours following a BW attack. The case-fatality rate in the US for food-borne botulism is 5 to 10 percent.
Symptoms usually begin with cranial nerve palsies, including ptosis, blurred vision, diplopia, dry mouth and throat, dysphagia, and dysphonia. These findings are followed by symmetrical descending flaccid paralysis, with generalized weakness and progression to respiratory failure. Symptoms begin as early as 12-36 hours after inhalation, but may take several days to develop after exposure to low doses of toxin.

Characteristic

Features

Symptoms (compiled from reports of foodborne botulism outbreaks caused by toxin types A, B, and E)b

—Nausea (88%)c
—Dry mouth (82%)
—Blurred vision (78%)
—Dysphonia (76%)
—Dysphagia (75%)
—Weakness (72%)
—Fatigue (69%)
—Dyspnea (65%)
—Dysarthria (63%)
—Double vision (60%)
—Dizziness (56%)
—Vomiting (52%)c
—Constipation (related to autonomic dysfunction) (45%)
—Sore throat (40%)
—Abdominal cramps or abdominal pain (40%)d
—Diarrhea (35%)c
—Paresthesias (29%)

Signs (compiled from cases of types A and B botulism reported to CDC in 1973 and 1974)d

—Alert mental status (90%)
—Weakness of upper extremities (75%)
—Ptosis (73%)
—Weakness of lower extremities (69%)
—Extraocular muscle weakness (65%)
—Diminished gag reflex (65%)
—Facial nerve dysfunction (63%)
—Dilated or fixed pupils (44%)
—Diminished or absent deep tendon reflexes in affected groups (40%)
—Nystagmus (22%)
—Ataxia (17%)
—Other considerations:
  ~Patients generally afebrile
  ~Mental status generally intact, although patients may appear lethargic
   or have difficulty communicating because of bulbar dysfunction
  ~Sensory exam generally normal

Find more information on this substance at: TOXNET , PubMed