The toxin causes a descending flaccid paralysis by binding irreversibly to the presynaptic membranes of the neuromuscular junction, blocking acetylcholine release.
Signs include:
- flaccid paralysis
- dysarthria
- ptosis
- fixed/dilated pupils
- dry mouth
- respiratory arrest
Botulism may be caused by food or by wound infection. Heroin users are at high risk.
All commericial canned food has to undergo a 'botulum cook' at 121C.
Honey can contain botulum and as a result it is not recommended to give honey to infants under 1 yr of age.
Botulism may cause a false positive tensilon result.
Treatment is with an antitoxin and ITU support.
Next up: hypertrophic cardiomyopathy
