Infantile botulism: Pitfalls in electrodiagnosis

Botulism in infants, unless recognized early, is associated with high morta lity and morbidity. The diagnosis is suspected when infants present with su dden onset of weakness, respiratory failure, and constipation and is confir med by demonstration of botulinum toxin in stool several weeks later. Elect rodiagnosis allows quick and reliable confirmation of botulism. Low-amplitu de compound muscle action potentials, tetanic or post-tetanic facilitation, and the absence of post-tetanic exhaustion support the diagnosis. Two infa nts with confirmed botulism did not exhibit the characteristic electrodiagn ostic features, demonstrating the pitfalls in electrodiagnosis of infantile botulism.