title: False-Positive Serum Botulism Bioassay in Miller-Fisher Syndrome.
abstract: We describe a patient with acute progressive weakness and areflexia. Both botulism and Miller-Fisher variant of Guillain-Barré syndrome were initial diagnostic considerations, and she was treated with intravenous immunoglobulin and botulinum antitoxin. A mouse bioassay was positive for botulinum toxin A, although her clinical course, electrodiagnostic studies, and cerebrospinal fluid findings supported Miller-Fisher syndrome. This patient's atypical features offer points of discussion regarding the evaluation of patients with acute neuromuscular weakness and emphasize the limitations of the botulism bioassay.
authors: *Department of Neurology, Duke University Hospital, Durham, NC; †Department of Neurology, State University of New York/Upstate Medical University, Syracuse, NY; ‡Department of Neurology, Aurora Neuroscience Innovation Institute, St. Luke's Medical Center, Milwaukee, WI; and §Department of Neurology, Cooper Medical School of Rowan University, Camden, NJ.
authors: Yuriy
authors: Y
authors: Zeylikman
authors: Vishal
authors: V
authors: Shah
authors: Umang
authors: U
authors: Shah
authors: Thomas R
authors: TR
authors: Mirsen
authors: Joseph V
authors: JV
authors: Campellone
mesh_terms: D000328:Adult; D001681:Biological Assay / Q000379:methods; D019274:Botulinum Toxins, Type A / Q000097:blood*; D001906:Botulism / Q000097:blood*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D019846:Miller Fisher Syndrome / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology
chemical_list: D019274:Botulinum Toxins, Type A