Botulism differential diagnosis: Difference between revisions
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| style="background: #DCDCDC; padding: 5px; text-align: center;" | Adult Botulism | | style="background: #DCDCDC; padding: 5px; text-align: center;" | Adult Botulism | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |<nowiki>+</nowiki> | | style="background: #F5F5F5; padding: 5px; text-align:center" |<nowiki>+</nowiki> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Generalized | | style="background: #F5F5F5; padding: 5px; text-align:center" |Generalized | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Descending | | style="background: #F5F5F5; padding: 5px; text-align:center" |Descending | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |BL | | style="background: #F5F5F5; padding: 5px; text-align:center" |BL | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Sudden | | style="background: #F5F5F5; padding: 5px; text-align:center" |Sudden | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Toxin test | | style="background: #F5F5F5; padding: 5px; text-align:center" |Toxin test | ||
| style="background: #F5F5F5; padding: 5px;" |Blood, Wound, or Stool culture | | style="background: #F5F5F5; padding: 5px;" |Blood, Wound, or Stool culture | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Infant Botulism | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Infant Botulism | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |+ | | style="background: #F5F5F5; padding: 5px; text-align:center" |+ | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |- | | style="background: #F5F5F5; padding: 5px; text-align:center" |- | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |+ | | style="background: #F5F5F5; padding: 5px; text-align:center" |+ | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |<nowiki>+</nowiki> | | style="background: #F5F5F5; padding: 5px; text-align:center" |<nowiki>+</nowiki> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Generalized | | style="background: #F5F5F5; padding: 5px; text-align:center" |Generalized | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Descending | | style="background: #F5F5F5; padding: 5px; text-align:center" |Descending | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |BL | | style="background: #F5F5F5; padding: 5px; text-align:center" |BL | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Sudden | | style="background: #F5F5F5; padding: 5px; text-align:center" |Sudden | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Toxin test | | style="background: #F5F5F5; padding: 5px; text-align:center" |Toxin test | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Blood, Wound, or Stool culture | | style="background: #F5F5F5; padding: 5px; text-align:center" |Blood, Wound, or Stool culture | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | | | style="background: #F5F5F5; padding: 5px; text-align:center" | | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" | [[Guillian-Barre syndrome]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" | [[Guillian-Barre syndrome]] | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |<nowiki>-</nowiki> | | style="background: #F5F5F5; padding: 5px; text-align:center" |<nowiki>-</nowiki> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Generalized | | style="background: #F5F5F5; padding: 5px; text-align:center" |Generalized | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Ascending | | style="background: #F5F5F5; padding: 5px; text-align:center" |Ascending | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |BL | | style="background: #F5F5F5; padding: 5px; text-align:center" |BL | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Insidious | | style="background: #F5F5F5; padding: 5px; text-align:center" |Insidious | ||
| style="background: #F5F5F5; padding: 5px;" |CSF: ↑Protein | | style="background: #F5F5F5; padding: 5px;" |CSF: ↑Protein | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" | [[Eaton lambert syndrome|Eaton Lambert syndrome]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" | [[Eaton lambert syndrome|Eaton Lambert syndrome]] | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |<nowiki>+</nowiki> | | style="background: #F5F5F5; padding: 5px; text-align:center" |<nowiki>+</nowiki> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Generalized | | style="background: #F5F5F5; padding: 5px; text-align:center" |Generalized | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Systemic | | style="background: #F5F5F5; padding: 5px; text-align:center" |Systemic | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |BL | | style="background: #F5F5F5; padding: 5px; text-align:center" |BL | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Intermittent | | style="background: #F5F5F5; padding: 5px; text-align:center" |Intermittent | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" |AB | | style="background: #F5F5F5; padding: 5px;" |AB | ||
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|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Myasthenia gravis]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Myasthenia gravis]] | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |<nowiki>+</nowiki> | | style="background: #F5F5F5; padding: 5px; text-align:center" |<nowiki>+</nowiki> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Generalized | | style="background: #F5F5F5; padding: 5px; text-align:center" |Generalized | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Systemic | | style="background: #F5F5F5; padding: 5px; text-align:center" |Systemic | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |BL | | style="background: #F5F5F5; padding: 5px; text-align:center" |BL | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Intermittent | | style="background: #F5F5F5; padding: 5px; text-align:center" |Intermittent | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" |Ach receptor antibody | | style="background: #F5F5F5; padding: 5px;" |Ach receptor antibody | ||
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|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Electrolyte disturbance]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Electrolyte disturbance]] | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |<nowiki>-</nowiki> | | style="background: #F5F5F5; padding: 5px; text-align:center" |<nowiki>-</nowiki> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Generalized | | style="background: #F5F5F5; padding: 5px; text-align:center" |Generalized | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Systemic | | style="background: #F5F5F5; padding: 5px; text-align:center" |Systemic | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |BL | | style="background: #F5F5F5; padding: 5px; text-align:center" |BL | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Insidious | | style="background: #F5F5F5; padding: 5px; text-align:center" |Insidious | ||
| style="background: #F5F5F5; padding: 5px;" | Electrolyte panel | | style="background: #F5F5F5; padding: 5px;" | Electrolyte panel | ||
| style="background: #F5F5F5; padding: 5px;" |↓Ca++, ↓Mg++, ↓K+ | | style="background: #F5F5F5; padding: 5px;" |↓Ca++, ↓Mg++, ↓K+ | ||
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|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Organophosphate poisoning|Organophosphate toxicity]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Organophosphate poisoning|Organophosphate toxicity]] | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |<nowiki>+</nowiki> | | style="background: #F5F5F5; padding: 5px; text-align:center" |<nowiki>+</nowiki> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Generalized | | style="background: #F5F5F5; padding: 5px; text-align:center" |Generalized | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Ascending | | style="background: #F5F5F5; padding: 5px; text-align:center" |Ascending | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |BL | | style="background: #F5F5F5; padding: 5px; text-align:center" |BL | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Sudden | | style="background: #F5F5F5; padding: 5px; text-align:center" |Sudden | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tick paralysis]] ([[Dermacentor andersoni|Dermacentor tick]]) | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tick paralysis]] ([[Dermacentor andersoni|Dermacentor tick]]) | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |<nowiki>-</nowiki> | | style="background: #F5F5F5; padding: 5px; text-align:center" |<nowiki>-</nowiki> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Generalized | | style="background: #F5F5F5; padding: 5px; text-align:center" |Generalized | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Ascending | | style="background: #F5F5F5; padding: 5px; text-align:center" |Ascending | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |BL | | style="background: #F5F5F5; padding: 5px; text-align:center" |BL | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Insidious | | style="background: #F5F5F5; padding: 5px; text-align:center" |Insidious | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
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|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tetrodotoxin]] poisoning | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Tetrodotoxin]] poisoning | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |<nowiki>+</nowiki> | | style="background: #F5F5F5; padding: 5px; text-align:center" |<nowiki>+</nowiki> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Generalized | | style="background: #F5F5F5; padding: 5px; text-align:center" |Generalized | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Systemic | | style="background: #F5F5F5; padding: 5px; text-align:center" |Systemic | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |BL | | style="background: #F5F5F5; padding: 5px; text-align:center" |BL | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Sudden | | style="background: #F5F5F5; padding: 5px; text-align:center" |Sudden | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
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|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Stroke]] | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Stroke]] | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | +/- | | style="background: #F5F5F5; padding: 5px; text-align:center" | +/- | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | +/- | | style="background: #F5F5F5; padding: 5px; text-align:center" | +/- | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | +/- | | style="background: #F5F5F5; padding: 5px; text-align:center" | +/- | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |<nowiki>+/-</nowiki> | | style="background: #F5F5F5; padding: 5px; text-align:center" |<nowiki>+/-</nowiki> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Generalized | | style="background: #F5F5F5; padding: 5px; text-align:center" |Generalized | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Systemic | | style="background: #F5F5F5; padding: 5px; text-align:center" |Systemic | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |UL | | style="background: #F5F5F5; padding: 5px; text-align:center" |UL | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Sudden | | style="background: #F5F5F5; padding: 5px; text-align:center" |Sudden | ||
| style="background: #F5F5F5; padding: 5px;" | MRI +ve for ischemia or hemorrhage | | style="background: #F5F5F5; padding: 5px;" | MRI +ve for ischemia or hemorrhage | ||
| style="background: #F5F5F5; padding: 5px;" |MRI | | style="background: #F5F5F5; padding: 5px;" |MRI | ||
Line 168: | Line 168: | ||
| style="background: #F5F5F5; padding: 5px; text-align:center" |+ | | style="background: #F5F5F5; padding: 5px; text-align:center" |+ | ||
| style="background: #F5F5F5; padding: 5px; text-align:center" |+ | | style="background: #F5F5F5; padding: 5px; text-align:center" |+ | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | | | style="background: #F5F5F5; padding: 5px; text-align:center" | | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Proximal > Distal | | style="background: #F5F5F5; padding: 5px; text-align:center" |Proximal > Distal | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Systemic | | style="background: #F5F5F5; padding: 5px; text-align:center" |Systemic | ||
| style="background: #F5F5F5; padding: 5px; text-align:center" |BL or UL | | style="background: #F5F5F5; padding: 5px; text-align:center" |BL or UL | ||
| style="background: #F5F5F5; padding: 5px; text-align:center" |Sudden | | style="background: #F5F5F5; padding: 5px; text-align:center" |Sudden | ||
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| style="background: #F5F5F5; padding: 5px; text-align:center" |+ | | style="background: #F5F5F5; padding: 5px; text-align:center" |+ | ||
| style="background: #F5F5F5; padding: 5px; text-align:center" |+ | | style="background: #F5F5F5; padding: 5px; text-align:center" |+ | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |<nowiki>+</nowiki> | | style="background: #F5F5F5; padding: 5px; text-align:center" |<nowiki>+</nowiki> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Proximal > Distal | | style="background: #F5F5F5; padding: 5px; text-align:center" |Proximal > Distal | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Systemic | | style="background: #F5F5F5; padding: 5px; text-align:center" |Systemic | ||
| style="background: #F5F5F5; padding: 5px; text-align:center" |BL or UL | | style="background: #F5F5F5; padding: 5px; text-align:center" |BL or UL | ||
| style="background: #F5F5F5; padding: 5px; text-align:center" |Sudden | | style="background: #F5F5F5; padding: 5px; text-align:center" |Sudden | ||
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|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Neurosyphilis]]<ref name="pmid22482824">{{cite journal| author=Liu LL, Zheng WH, Tong ML, Liu GL, Zhang HL, Fu ZG et al.| title=Ischemic stroke as a primary symptom of neurosyphilis among HIV-negative emergency patients. | journal=J Neurol Sci | year= 2012 | volume= 317 | issue= 1-2 | pages= 35-9 | pmid=22482824 | doi=10.1016/j.jns.2012.03.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22482824 }} </ref><ref name="pmid24365430">{{cite journal |vauthors=Berger JR, Dean D |title=Neurosyphilis |journal=Handb Clin Neurol |volume=121 |issue= |pages=1461–72 |year=2014 |pmid=24365430 |doi=10.1016/B978-0-7020-4088-7.00098-5 |url=}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Neurosyphilis]]<ref name="pmid22482824">{{cite journal| author=Liu LL, Zheng WH, Tong ML, Liu GL, Zhang HL, Fu ZG et al.| title=Ischemic stroke as a primary symptom of neurosyphilis among HIV-negative emergency patients. | journal=J Neurol Sci | year= 2012 | volume= 317 | issue= 1-2 | pages= 35-9 | pmid=22482824 | doi=10.1016/j.jns.2012.03.003 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22482824 }} </ref><ref name="pmid24365430">{{cite journal |vauthors=Berger JR, Dean D |title=Neurosyphilis |journal=Handb Clin Neurol |volume=121 |issue= |pages=1461–72 |year=2014 |pmid=24365430 |doi=10.1016/B978-0-7020-4088-7.00098-5 |url=}}</ref> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | | | style="background: #F5F5F5; padding: 5px; text-align:center" | | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Generalized | | style="background: #F5F5F5; padding: 5px; text-align:center" |Generalized | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Systemic | | style="background: #F5F5F5; padding: 5px; text-align:center" |Systemic | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |BL | | style="background: #F5F5F5; padding: 5px; text-align:center" |BL | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Insidious<nowiki/> | | style="background: #F5F5F5; padding: 5px; text-align:center" |Insidious<nowiki/> | ||
| style="background: #F5F5F5; padding: 5px;" |MRI & Lumbar puncture | | style="background: #F5F5F5; padding: 5px;" |MRI & Lumbar puncture | ||
| style="background: #F5F5F5; padding: 5px;" |CSF [[VDRL]]-specifc | | style="background: #F5F5F5; padding: 5px;" |CSF [[VDRL]]-specifc | ||
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|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align:center;" |[[Muscular dystrophy]] | | style="background: #DCDCDC; padding: 5px; text-align:center;" |[[Muscular dystrophy]] | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |<nowiki>-</nowiki> | | style="background: #F5F5F5; padding: 5px; text-align:center" |<nowiki>-</nowiki> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Proximal > Distal | | style="background: #F5F5F5; padding: 5px; text-align:center" |Proximal > Distal | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Systemic | | style="background: #F5F5F5; padding: 5px; text-align:center" |Systemic | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |BL | | style="background: #F5F5F5; padding: 5px; text-align:center" |BL | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Insidious | | style="background: #F5F5F5; padding: 5px; text-align:center" |Insidious | ||
| style="background: #F5F5F5; padding: 5px;" | Genetic testing | | style="background: #F5F5F5; padding: 5px;" | Genetic testing | ||
| style="background: #F5F5F5; padding: 5px;" |Muscle biopsy | | style="background: #F5F5F5; padding: 5px;" |Muscle biopsy | ||
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|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Multiple sclerosis]] exacerbation | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Multiple sclerosis]] exacerbation | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |<nowiki>+</nowiki> | | style="background: #F5F5F5; padding: 5px; text-align:center" |<nowiki>+</nowiki> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Generalized | | style="background: #F5F5F5; padding: 5px; text-align:center" |Generalized | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Systemic | | style="background: #F5F5F5; padding: 5px; text-align:center" |Systemic | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |NL | | style="background: #F5F5F5; padding: 5px; text-align:center" |NL | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Sudden | | style="background: #F5F5F5; padding: 5px; text-align:center" |Sudden | ||
| style="background: #F5F5F5; padding: 5px; text-align:center" |'''↑'''CSF IgG levels | | style="background: #F5F5F5; padding: 5px; text-align:center" |'''↑'''CSF IgG levels | ||
(monoclonal bands) | (monoclonal bands) | ||
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| style="background: #DCDCDC; padding: 5px; text-align:center;" |[[Amyotrophic lateral sclerosis]] | | style="background: #DCDCDC; padding: 5px; text-align:center;" |[[Amyotrophic lateral sclerosis]] | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | + | | style="background: #F5F5F5; padding: 5px; text-align:center" | + | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |<nowiki>-</nowiki> | | style="background: #F5F5F5; padding: 5px; text-align:center" |<nowiki>-</nowiki> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Generalized | | style="background: #F5F5F5; padding: 5px; text-align:center" |Generalized | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Systemic | | style="background: #F5F5F5; padding: 5px; text-align:center" |Systemic | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |BL | | style="background: #F5F5F5; padding: 5px; text-align:center" |BL | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Insidious | | style="background: #F5F5F5; padding: 5px; text-align:center" |Insidious | ||
| style="background: #F5F5F5; padding: 5px;" | Normal LP (to rule out DDx) | | style="background: #F5F5F5; padding: 5px;" | Normal LP (to rule out DDx) | ||
| style="background: #F5F5F5; padding: 5px;" |MRI & LP | | style="background: #F5F5F5; padding: 5px;" |MRI & LP | ||
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| style="background: #F5F5F5; padding: 5px; text-align:center" |- | | style="background: #F5F5F5; padding: 5px; text-align:center" |- | ||
| style="background: #F5F5F5; padding: 5px; text-align:center" | - | | style="background: #F5F5F5; padding: 5px; text-align:center" | - | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |<nowiki>-</nowiki> | | style="background: #F5F5F5; padding: 5px; text-align:center" |<nowiki>-</nowiki> | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Proximal > Distal | | style="background: #F5F5F5; padding: 5px; text-align:center" |Proximal > Distal | ||
| style="background: #F5F5F5; padding: 5px text-align:center" |Systemic | | style="background: #F5F5F5; padding: 5px; text-align:center" |Systemic | ||
| style="background: #F5F5F5; padding: 5px; text-align:center" |UL or BL | | style="background: #F5F5F5; padding: 5px; text-align:center" |UL or BL | ||
| style="background: #F5F5F5; padding: 5px; text-align:center" |Insidious | | style="background: #F5F5F5; padding: 5px; text-align:center" |Insidious |
Revision as of 21:29, 22 May 2017
Botulism Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Botulism differential diagnosis On the Web |
American Roentgen Ray Society Images of Botulism differential diagnosis |
Risk calculators and risk factors for Botulism differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Michael Maddaleni, B.S.
Overview
Botulism must be differentiated from neuromuscular disorders that present with muscle weakness and flaccidity.
Differentiating Botulism from other Diseases
Botulism must be differentiated from neuromuscular disorders that present with muscle weakness and flaccidity, such as:
Diseases | History and Physical | Diagnostic tests | Other Findings | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Motor Deficit | Sensory deficit | Cranial nerve Involvement | Autonomic dysfunction | Proximal/Distal/Generalized | Ascending/Descending/Systemic | Unilateral (UL)
or Bilateral (BL) or No Lateralization (NL) |
Onset | Lab or Imaging Findings | Specific test | ||
Adult Botulism | + | - | + | + | Generalized | Descending | BL | Sudden | Toxin test | Blood, Wound, or Stool culture | |
Infant Botulism | + | - | + | + | Generalized | Descending | BL | Sudden | Toxin test | Blood, Wound, or Stool culture | |
Guillian-Barre syndrome | + | - | - | - | Generalized | Ascending | BL | Insidious | CSF: ↑Protein
↓Cells |
Clinical & Lumbar Puncture | |
Eaton Lambert syndrome | + | - | + | + | Generalized | Systemic | BL | Intermittent | AB | ||
Myasthenia gravis | + | - | + | + | Generalized | Systemic | BL | Intermittent | Ach receptor antibody | ||
Electrolyte disturbance | + | + | - | - | Generalized | Systemic | BL | Insidious | Electrolyte panel | ↓Ca++, ↓Mg++, ↓K+ | |
Organophosphate toxicity | + | + | - | + | Generalized | Ascending | BL | Sudden | |||
Tick paralysis (Dermacentor tick) | + | - | - | - | Generalized | Ascending | BL | Insidious | |||
Tetrodotoxin poisoning | + | - | + | + | Generalized | Systemic | BL | Sudden | |||
Stroke | +/- | +/- | +/- | +/- | Generalized | Systemic | UL | Sudden | MRI +ve for ischemia or hemorrhage | MRI | |
Poliomyelitis | + | + | + | Proximal > Distal | Systemic | BL or UL | Sudden | PCR of CSF | |||
Transverse myelitis | + | + | + | + | Proximal > Distal | Systemic | BL or UL | Sudden | MRI & Lumbar puncture | MRI | |
Neurosyphilis[1][2] | + | + | - | Generalized | Systemic | BL | Insidious | MRI & Lumbar puncture | CSF VDRL-specifc
CSF FTA-Ab -sensitive[3] |
||
Muscular dystrophy | + | - | - | - | Proximal > Distal | Systemic | BL | Insidious | Genetic testing | Muscle biopsy | |
Multiple sclerosis exacerbation | + | + | + | + | Generalized | Systemic | NL | Sudden | ↑CSF IgG levels
(monoclonal bands) |
Clinical assesment and MRI [4] | Blurry vision, urinary incontinence, fatigue |
Amyotrophic lateral sclerosis | + | - | - | - | Generalized | Systemic | BL | Insidious | Normal LP (to rule out DDx) | MRI & LP | |
Myositis | + | - | - | - | Proximal > Distal | Systemic | UL or BL | Insidious | Elevated CK & Aldolase | Muscle biopsy |
References
- ↑ Liu LL, Zheng WH, Tong ML, Liu GL, Zhang HL, Fu ZG; et al. (2012). "Ischemic stroke as a primary symptom of neurosyphilis among HIV-negative emergency patients". J Neurol Sci. 317 (1–2): 35–9. doi:10.1016/j.jns.2012.03.003. PMID 22482824.
- ↑ Berger JR, Dean D (2014). "Neurosyphilis". Handb Clin Neurol. 121: 1461–72. doi:10.1016/B978-0-7020-4088-7.00098-5. PMID 24365430.
- ↑ Ho EL, Marra CM (2012). "Treponemal tests for neurosyphilis--less accurate than what we thought?". Sex Transm Dis. 39 (4): 298–9. doi:10.1097/OLQ.0b013e31824ee574. PMC 3746559. PMID 22421697.
- ↑ Giang DW, Grow VM, Mooney C, Mushlin AI, Goodman AD, Mattson DH; et al. (1994). "Clinical diagnosis of multiple sclerosis. The impact of magnetic resonance imaging and ancillary testing. Rochester-Toronto Magnetic Resonance Study Group". Arch Neurol. 51 (1): 61–6. PMID 8274111.