Food-borne botulism cases in Van region in eastern Turkey: importance of electromyography in the diagnosis.
OBJECTIVE
Food-borne botulism is an acute form of poisoning that results from ingestion of a toxin produced by Clostridium botulinum. Botulism toxin causes its major effect by blocking neuromuscular transmission in autonomic and motor nerve terminals.


METHODS
In this study, we present the features of eleven cases of food-borne botulism admitted to our hospital in 2001. All of the cases were caused by home-prepared foods; green beans. In these cases, the main symptoms and signs were generalized muscular weakness, dry mouth, dysphagia, disponea and diplopia. Electrophysiological studies were performed on four patients.


RESULTS
Motor conduction studies showed that compound muscle action potentials were decreased with normal latencies and conduction velocities. The needle electromyography showed signs of denervation potentials like fibrillation and positive waves in four patients. Repetitive nerve stimulation with high frequency (20 Hz) induced an increment close to 100% in the amplitudes in 2 of 4 patients.


CONCLUSIONS
Although toxin could not be detected in the patients, the electromyographic findings supported our diagnosis. We concluded that electromyography has an important role in diagnosis of botulism, especially in the condition that serologic tests are negative or cannot be performed.
Anlar
O
O
Department of Neurology, Yuzuncu Yil University, Faculty of Medecine, 65200 Van, Turkey. omeranlar@yyu.edu.tr
Irmak
H
H
Tombul
T
T
Akdeniz
H
H
Caksen
H
H
Kose
D
D
Ceylan
A
A
D000200:Action Potentials; D000328:Adult; D001906:Botulism / Q000150:complications / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004576:Electromyography; D005260:Female; D005506:Food Contamination; D006801:Humans; D008297:Male; D009046:Motor Neurons / Q000473:pathology* / Q000502:physiology; D018908:Muscle Weakness / Q000209:etiology / Q000473:pathology; D009431:Neural Conduction; D014421:Turkey