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Titolo:
CLUSTER OF WOUND BOTULISM IN CALIFORNIA - CLINICAL, ELECTROPHYSIOLOGIC, AND PATHOLOGICAL-STUDY
Autore:
MASELLI RA; ELLIS W; MANDLER RN; SHEIKH F; SENTON G; KNOX S; SALARINAMIN H; AGIUS M; WOLLMANN RL; RICHMAN DP;
Indirizzi:
UNIV CALIF DAVIS,DEPT NEUROL,1515 NEWTON COURT,ROOM 502 DAVIS CA 95616 UNIV CALIF DAVIS,DEPT PATHOL DAVIS CA 95616 UNIV CHICAGO,DEPT PATHOL CHICAGO IL 60637
Titolo Testata:
Muscle & nerve
fascicolo: 10, volume: 20, anno: 1997,
pagine: 1284 - 1295
SICI:
0148-639X(1997)20:10<1284:COWBIC>2.0.ZU;2-K
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEUROMUSCULAR-TRANSMISSION; INVITRO MICROELECTRODE; MYASTHENIC SYNDROME; NERVE-TERMINALS; ANTIBODIES; ENDPLATE; SNAP-25; MUSCLE; GRAVIS;
Keywords:
WOUND BOTULISM; NEUROMUSCULAR JUNCTION; ADDICTION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
46
Recensione:
Indirizzi per estratti:
Citazione:
R.A. Maselli et al., "CLUSTER OF WOUND BOTULISM IN CALIFORNIA - CLINICAL, ELECTROPHYSIOLOGIC, AND PATHOLOGICAL-STUDY", Muscle & nerve, 20(10), 1997, pp. 1284-1295

Abstract

Over a period of 15 months we have seen 6 patients with long-standinghistory of subcutaneous heroin injections who experienced acute blurred vision, dysphagia, dysarthria, and generalized weakness. Decreased or absent deep tendon reflexes, pupillary abnormalities, incremental responses to fast repetitive nerve stimulation, and positive serology for Clostridia botulinum toxin A were found, but not in all cases. Muscle biopsies showed variable signs of neurogenic atrophy. In vitro electrophysiology studies revealed decreased end-plate potentials quantal content, confirming the presynaptic nature of the disorder, Mechanicalventilation was required in 5 patients. Half of the patients were treated with polyvalent antitoxiin. Prognosis was favorable, though recovery was slow. In conclusion, acute bulbar weakness with visual symptoms in patients with subcutaneous heroin abuse strongly suggets the possibility of wound botulism. High diagnostic suspicion combined with histology and in vitro electrophysiology confirmation of presynaptic failure, especially in seronegative cases, may significantly improve morbidity. (C) 1997 John Wiley & Sons, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 06:57:15