| Progression of clinical signs in severe infant botulism. Therapeutic implications. | |
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MedLine Citation:
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PMID: 6257443 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The clinical evaluation of nine patients with severe infant botulism revealed an identifiable progression of signs due to blockade of the cholinergic synapse similar to that described for competitive blocking agents. This predictable sequence reflects different "margins of safety" for muscles involved in repetitive activities, diaphragmatic function and movement of the extremities. It is important for the clinician to realize that return of peripheral motor activity does not signify a completely recovered cholinergic synapse. Instead of having a four- to five-fold margin of safety, the infant remains close to the point of neuromuscular blockade. Added insults or stress to neuromuscular transmission may precipitate respiratory failure. An understanding of the signs associated with progressive impairment of cholinergic synapses both during onset and during resolution of disease will allow safe care of the infant and will diminish the risk of iatrogenic complications. Evaluation of head control is the most sensitive physical finding indicative of return of adequate neuromuscular function and signifies that oral feedings can be reinstituted. |
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Authors:
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C L'Hommedieu; R A Polin |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Clinical pediatrics Volume: 20 ISSN: 0009-9228 ISO Abbreviation: Clin Pediatr (Phila) Publication Date: 1981 Feb |
Date Detail:
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Created Date: 1981-04-21 Completed Date: 1981-04-21 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0372606 Medline TA: Clin Pediatr (Phila) Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 90-5 Citation Subset: AIM; IM |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Autonomic Nervous System
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physiopathology Autonomic Nervous System Diseases / etiology Botulism / complications, physiopathology* Female Humans Infant Motor Activity / physiology Muscles / physiopathology Neuromuscular Junction / physiopathology Respiratory Insufficiency / etiology Stress, Physiological / complications Synaptic Transmission |
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