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自从1976年有人发现婴儿肉毒中毒以来,本病在美国各地均有报告,发病数比已诊断的病例还要多,其特征为急性软弱无力。最早报告的两例是正常足月产儿,母乳喂养。病前无异常发现,分别于生后6、11周发病,在1～2天内变得不能吸吮和吞咽,且伴全身软弱。病后1～2周住院时,体检发现明显地软弱,头不能竖,哭声细微,睑下垂,瞳孔对光反射迟钝。面部活动、张口反射(gag reflex)及伸展反射均减低,肌张力严重减弱。例1提示有末梢运动神经分枝、神经肌肉终板或肌纤维异常。这些发现见于肉毒中毒和其它疾病。例2提示神经肌肉终板处缺乏乙酰胆碱释放。这一发现见于肉毒中毒,Lambert-Eaton综合征,某些抗菌素中毒,高镁、高锰及低钙血症或毒蛇咬伤。虽然未发
Since the discovery of infant botulism in 1976, the disease has been reported in various parts of the United States, with more cases reported than previously diagnosed and characterized by acute weakness. Two of the earliest reports were normal full-term infants and breastfeeding. No abnormalities were found before the disease, respectively, 6 weeks after birth onset, in 1 to 2 days can not be sucked and swallowed, and with the whole body weak. 1 to 2 weeks after illness hospitalization, physical examination found significantly weak, head can not be vertical, crying subtle, ptosis, pupillary light reflex slow. Facial activity, gag reflex and extension reflex were reduced, severely weakened muscle tone. Example 1 suggests peripheral motor nerve branches, neuromuscular endplate or abnormal muscle fibers. These findings are found in botulism and other diseases. Example 2 suggests a lack of release of acetylcholine at the neuromuscular endplate. This finding is seen in botulism, Lambert-Eaton syndrome, some antibiotic poisonings, high magnesium, high manganese and hypocalcemia or snakebite. Although not issued