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Michael P. McQuillen, MD; Lorraine F. Josifek

Arch Neurol. 1972;26(4):320-325.

Abstract
A 4-year-old boy developed oculobulbar paralysis with fixed dilated pupils in the face of a normal level of consciousness. Serological and bacteriological studies did not confirm a diagnosis of botulism, but electromyographic changes supported the diagnosis, especially since no other cause for the patient's clinical state was found. Electromyographic abnormalities included a very small grouped muscle action potential (MAP) response to a single nerve stimulus; marked tetanic and posttetanic MAP facilitation at fast rates of repetitive nerve stimulation; increased nerve excitability; and a "supernormal" mixed nerve action potential response, enhanced after a calcium infusion.

Author Affiliations
Lexington, Ky

From the Department of Neurology, the University of Kentucky Medical Center, Lexington.

Footnotes
Accepted for publication Aug 31, 1971.

Read in part before the annual meeting of the American Neurological Association, Washington, DC, June 14, 1971.

Reprint requests to the Department of Neurology, University of Kentucky Medical Center, Lexington, Ky 40506 (Dr. McQuillen).

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