Case Report
An Asymmetric Onset of Neurological Signs Does Not Rule Out the Botulism
Marina Trivisano1, Giuseppe d’Orsi2*, Adele Gianmario1, Marianna Ciarallo1, Maria E. Liuni1, Giovanna D’Addiego2, Anna Lepore3, Teresa Santantonio1and Luigi M. Specchio1 | |
1Clinic of Nervous System Diseases, University of Foggia, Foggia, Italy | |
2Clinic of Infectious Diseases, University of Foggia, Foggia, Italy | |
3Poison Control Center, Riuniti Hospital, Foggia, Italy | |
Corresponding Author : | Giuseppe d’Orsi Department of Neurological Sciences Clinic of Nervous System, Diseases University of Foggia, Riuniti Hospital Via Luigi Pinto 1, 71100 Foggia. Italy Tel: 0039-0881/736125 E-mail: giudorsi@yahoo.it |
Received September 17, 2015; Accepted September 28, 2015; Published September 30, 2015 | |
Citation:Trivisano M, D’Orsi G, Gianmario A, Ciarallo M, Liuni ME, et al. (2015) An Asymmetric Onset of Neurological Signs Does Not Rule Out the Botulism. J Neuroinfect Dis 6:188. doi:10.4172/2314-7326.1000188 | |
Copyright: ©2015 Trivisano M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited | |
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Abstract
Foodborne Botulism is clinically characterized by a symmetric flaccid paralysis of the cranial nerves with a descending involvement of voluntary and breathing muscles leading to respiratory arrest. Asymmetric neurological signs are unusual and in these cases diagnosis could be delayed or frequently missed. We described a 63-year-old man with a clinical picture related to type A botulism characterized by an asymmetric and left lateralized onset of neurological signs associated with a monolateral parotitis. Physicians must be aware that lateralized onset of neurological signs does not rule out the botulism, and it should be considered even in cases of atypical clinical picture.