[Treatment of severe botulism with 3,4-diaminopyridine]].
BACKGROUND
The specific treatments of botulism with serotherapy and with guanidine are of debatable efficacy. We report a case of nutritional toxin B botulism successfully treated with 3,4-diaminopyridine.


METHODS
Following a meal, a 69 year-old woman consulted for digestive disorders followed by damage to several cranial pairs, autonomous nervous system and ventilation command, motivating mechanical ventilation on tracheal intubation. Administration of symptomatic treatment with 3,4-diaminopyridine led to progressive improvement, although the diagnosis of toxin B botulism was confirmed.


CONCLUSIONS
Administration of 3,4-diaminopyridine, the efficacy of which had been suggested by the review of experimental literature, led to rapid and clear improvement, probably due to its potentiating effect on acetylcholine release in the neuromuscular junction.
Dock
M
M
Fondation Hôpital Saint-Joseph, Paris.
Ben Ali
A
A
Karras
A
A
Misset
B
B
Garrouste-Orgeas
M
M
Deletie
E
E
Goldstein
F
F
Carlet
J
J
D015761:4-Aminopyridine / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives*; D000109:Acetylcholine / Q000378:metabolism; D000368:Aged; D000077770:Amifampridine; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A; D001906:Botulism / Q000175:diagnosis / Q000188:drug therapy* / Q000635:transmission; D005260:Female; D005517:Foodborne Diseases / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D009469:Neuromuscular Junction / Q000187:drug effects; D016896:Treatment Outcome
C096323:rimabotulinumtoxinB; D015761:4-Aminopyridine; D001905:Botulinum Toxins; D019274:Botulinum Toxins, Type A; D000109:Acetylcholine; D000077770:Amifampridine