We quantified antibodies to botulinum A (anti-BTx) by immunoprecipitat
ion of I-125-BTX. We tested seven bioassay-positive sera and 68 coded
samples, including 18 from patients who had ceased to respond to BTx t
reatment. Compared with values from healthy control subjects and 42 ne
urologic control subjects, all bioassay-positive sera were positive (r
ange, 258 to 2,809 pM) and 49 of 50 patients who continued to respond
to BTx were negative (<130 pM). This simple, specific, sensitive, and
quantitative assay should prove helpful in the investigation of BTx re
sistance.