Serum positive botulism with neuropathic features

A 32-year-old man presented with multiple cranial neuropathies and his seru m was positive for botulism type B. However, serial electrodiagnostic studi es were consistent with a primarily neuropathic process, such as Fisher syn drome, rather than a neuromuscular junction disorder. Electrodiagnostic stu dy findings in patients with presumed neuromuscular junction disorders may mimic findings suggestive of a neuropathic process, or the bioassay for bot ulism may be falsely positive in patients with Fisher Syndrome.