AI Article Synopsis
- * His symptoms included severe eyelid drooping (ptosis), eye movement paralysis (ophthalmoplegia), and weakness in his neck and arms, alongside a recent arm fracture requiring amputation.
- * After inconclusive tests and ongoing weakness despite treatment, they identified botulinum toxin too late for effective antitoxin; however, he eventually recovered well neurologically and no longer needed respiratory support.
Article Abstract
A 41-year-old man developed rapidly progressive cranial neuropathies and muscle weakness followed by respiratory failure, requiring ventilation support. On examination, there was marked bilateral ptosis and ophthalmoplegia with bulbar, neck and proximal upper limb weakness. He had a recent open left humeral fracture that eventually required amputation. Despite immunoglobulin therapy, his progressive weakness continued. Multiple investigation results were inconclusive. Eventually, botulinum type A toxin was found positive, by which time the therapeutic window for antitoxin had passed. He continued on supportive management and was treated for concomitant infections and nosocomial illnesses. He was subsequently weaned from respiratory support and has made a good neurological recovery.
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| http://dx.doi.org/10.1136/pn-2023-004036 | DOI Listing |
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