Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\26697417
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Front+Pediatr
2015 ; 3
(ä): 108
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Abnormal Neuroimaging in a Case of Infant Botulism
#MMPMID26697417
Good RJ
; Messacar K
; Stence NV
; Press CA
; Carpenter TC
Front Pediatr
2015[]; 3
(ä): 108
PMID26697417
show ga
We present the first case of abnormal neuroimaging in a case of infant botulism.
The clinical findings of the patient with constipation, bulbar weakness, and
descending, symmetric motor weakness are consistent with the classic findings of
infant botulism. Magnetic resonance imaging (MRI), however, revealed restricted
diffusion in the brain and enhancement of the cervical nerve roots.
Traditionally, normal neuroimaging was used to help differentiate infant botulism
from other causes of weakness in infants. Abnormal neuroimaging is seen in other
causes of weakness in an infant including metabolic disorders and
hypoxic-ischemic injury, but these diagnoses did not fit the clinical findings in
this case. The explanation for the MRI abnormalities in the brain and cervical
nerve roots is unclear as botulinum toxin acts at presynaptic nerve terminals and
does not cross the blood-brain barrier. Possible explanations for the findings
include inflammation from the botulinum toxin at the synapse, alterations in
sensory signaling and retrograde transport of the botulinum toxin. The patient
was treated with human botulism immune globulin and had rapid recovery in
weakness. A stool sample from the patient was positive for Type A Clostridium
botulinum toxin eventually confirming the diagnosis of infant botulism. The
findings in this case support use of human botulism immune globulin when the
clinical findings are consistent with infant botulism despite the presence of MRI
abnormalities in the brain and cervical nerve roots.
free
free
free
