神经系统表现为主的肉毒杆菌中毒三例

Neurological manifestations of botulism

目的探讨肉毒杆菌中毒的神经系统表现。方法分析3例肉毒杆菌中毒患者的临床资料。结果 3例患者病前均食用变质酸豆酱,以眼肌无力为首发症状。2例(例1,例2)患者出现呼吸困难,经注射A型、B型肉毒抗毒素、机械辅助呼吸后症状好转。3例患者经2年随访均无后遗症及复发。结论肉毒杆菌中毒主要表现为眼部、口咽部麻痹、四肢对称性驰缓性瘫痪等症状,严重者出现呼吸衰竭。早期诊断、尽早、足量使用肉毒抗毒素是救治的关键。

Objective To explore the neurological manifestations of botulism.Method The clinical data of three patients diagnosed with botulism were analyzed.Results Three patients presented with ocular paralysis and they were onset due to taking homemade perishable soybean paste.Two patients(case1,case2)suffered from respiratory difficulty.Their condition were significantly improved after giving anti-botulinum toxins A,B and mechanical ventilation.The patients had no complications and recurrence during2years follow-up after discharge from hospital.Conclusion Ocular and pharynx oralis paralysis,symmetrical flaccid paralysis of extremities are presenting symptoms in patients with botulism.Respiratory failure occurred in some severe cases.Early diagnosis,early and adequate application of botulinum antitoxins are the key points for the treatment of botulism.