Botulinum polyneuropathy

Botulinum polyneuropathy is also characterized by damage to motor functions, however, the site of the toxic effect is not the nerve trunks, but the areas of their endings. The specificity of this type of polyneuropathy is that it is not a complication of the disease, but its mandatory manifestation. Botulinum poison is very strong, always fatal in contact with the brain. However, when a person is poisoned through the mouth, the poison does not penetrate the central nervous system, since it does not overcome the blood-brain barrier. In the cerebrospinal fluid it is not detected. The site of exposure to botulinum poison remains only the area of ​​neuromuscular transmission. In this regard, the mechanism of acetylcholine release is disrupted, the number of its quanta decreases (unlike myasthenia gravis, in which the amount of mediator in each quantum decreases). Hence, the predominant lesion of certain muscles, mainly the oculomotor, pharyngeal (especially reacting under conditions of denervation to acetylcholine), the absence of atrophy, the preservation of consciousness in the presence of gross violations of articulation, swallowing. It should be emphasized again that the mediator neuromuscular defect is the basis of the described boulevard syndrome . Clinical manifestations begin within a few hours after consuming poor-quality canned food, sausages, in which the botulism bacillus multiplies. Vomiting, diarrhea, abdominal pain, dry mucous membranes and skin appear. Soon, paralysis of accommodation, reflex stillness of dilated pupils, double vision, disturbances of phonation, swallowing, muscle weakness, especially the neck, join; in the absence of adequate treatment, death occurs in 50-60% of cases. The beginning regression of symptoms goes to a full recovery. 

local_offerevent_note September 29, 2019

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