ABSTRACT

Botulinum, a neurotoxin with muscle relaxant properties, is used in the treatment of strabismus.

Botulism antitoxin, which binds and neutralizes toxin, is used in the treatment of botulism.

Botulinum neurotoxin

is produced by the anaerobic bacterium

Clostridium botulinum

. It is the most poisonous substance known. Very small amounts of botulinum toxin can lead to botulism, a descending paralysis with prominent bulbar symptoms and often affecting the autonomic nervous system (see Chapter 12). Botulism can occur in two ways. It can result from infection with bacterial spores that produce and release the toxin in the body, as in

enteric infectious botulism

, when the bacteria grow in the intestine, and in

wound botulism

, when the wound becomes infected. Alternatively, botulism occurs after ingestion of the toxin (

food-borne botulism

).