title: Diplopia as the primary presentation of foodborne botulism.
abstract: Foodborne botulism is a serious condition caused by Clostridium botulinum neurotoxin. Clinically, botulism presents as bilateral cranial nerve neuropathy and descending paralysis. We report a unique presentation of botulism to remind clinicians of this potentially fatal condition. In this observational case report initial evaluation showed only esodeviation. This progressed to unilateral cranial nerve six (CN VI) paresis along with systemic signs. Clinical diagnosis was made based on in-depth history and concurrent symptoms in three other patients. Foodborne botulism presenting as diplopia and unilateral motility deficits is rare and can represent a diagnostic and therapeutic challenge to the ophthalmologist.
authors.affiliation: Eye Research Center, Khatam Al-Anbia Hospital, Department of Ophthalmology, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Khakshoor
authors.forename: Ali Akbar Saber
authors.initials: AA
authors.lastname: Moghaddam
authors.forename: Amir Hossein
authors.initials: AH
authors.lastname: Vejdani
authors.forename: Blair K
authors.initials: BK
authors.lastname: Armstrong
authors.forename: Majid
authors.initials: M
authors.lastname: Moshirfar