Cardiovascular-Reflex Testing and Single-Fiber Electromyography in Botulism

Vita, Giuseppe; Girlanda, Paolo; Puglisi, R. M.; Marabello, L.; Messina, C

doi:10.1001/archneur.1987.00520140064019

Cited by 61 publications

(27 citation statements)

References 27 publications

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“…The finding that botulism can markedly impair control of heart rate variability and blood pressure response is in line with two other reports on cardiovascular functions in botulism [2,20]. However, our study protocol included not only well established tests for the evaluation of sympathovagal modulation of heart rate and blood pressure, but also the non-invasive measurement of baroreflex function-the most powerful reflex for cardiovascular stabilisation [5].…”

Section: Discussionsupporting

confidence: 69%

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Quantitative autonomic testing in the management of botulism

Topakian¹,

Heibl

Stieglbauer³

et al. 2009

J Neurol

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Even with mild neurological signs, patients with botulism frequently complain of autonomic symptoms. This study aimed at the evaluation of sudomotor and cardiovascular reflex functions by quantitative autonomic testing (QAT), which may identify patients with autonomic involvement but otherwise benign clinical presentation. Five patients with food-borne botulism were subjected to a structured questionnaire on autonomic symptoms, cardiac and neurological examination, and QAT after a median of 2 weeks (baseline) and 12 weeks (follow-up) post intoxication. For calculation of haemodynamic and cardiovascular autonomic parameters, we used the Task Force((R)) Monitor (Version 2.1, CNSystems, Graz, Austria). Cardiovagal function was assessed by Ewing's test battery. Autonomic complaints were more pronounced than neurological symptoms. Baseline tests revealed widely abnormal sudomotor function and marked impairment of heart rate variation and blood pressure response to standing. Prominent features of cardiovascular failure were high resting heart rate, supine hypertension, orthostatic hypotension, and impaired baroreflex function. Three patients reported inability to keep up with their routine amount of physical work. Based on the baseline QAT results, these three patients were instructed to engage in physical activity but avoid physical strain until there was considerable improvement. On follow-up, fatigue was the most frequent residual complaint, sympathetic skin responses were present, and cardiovascular QAT results were significantly improved and did not differ from those of ten control subjects. QAT identified autonomic involvement in botulism patients with otherwise benign neurological presentation. Comprehensive evaluation of autonomic failure may provide useful information for the management of botulism.

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Section: Discussionsupporting

confidence: 69%

“…Because severe impairment of cardiovascular autonomic functions carries the risk of cardiac complications, patient management might benefit from a systematic evaluation of the autonomic derangement in botulism. However, only few reports focus on the assessment of cardiovascular reflex functions in botulism [2,20].…”

Section: Introductionmentioning

confidence: 99%

Quantitative autonomic testing in the management of botulism

Topakian¹,

Heibl

Stieglbauer³

et al. 2009

J Neurol

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“…Since all the patients with CD we studied had been receiving BoNT-A therapy for several years their ANS dysfunction might well depend on chronic treatment.Autonomic complications are among the main symptoms of botulism intoxication [6,26]. In patients with various focal movement disorders, Girlanda and colleagues [10] showed an effect of local BoNT-A injection on muscles distant from the site of inoculation (as seen on single-fibre EMG) and also on cardiovascular autonomic pathways (as seen on standard cardiovascular reflex testing).…”

Section: Discussionmentioning

confidence: 99%

Autonomic cardiovascular function and baroreflex sensitivity in patients with cervical dystonia receiving treatment with botulinum toxin type A

et al. 2008

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“…A battery of cardiovascular-reflex function tests was performed as previously described [12,13], R-R interval variation test, deep breathing, Valsalva manoeuvre and heart rate response to standing are known to involve parasympathetic nervous system pathways (heart rate tests), whereas blood pressure responses to standing and to sustained handgrip allow the assessment of the sympathetic sys tem activity (blood pressure tests).…”

Section: Autonomic Testsmentioning

confidence: 99%

Comparative Analysis of Autonomic and Somatic Dysfunction in Chronic Uraemia

et al. 1988

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The relationship between autonomic dysfunction and peripheral somatic neuropathy was investigated in uraemics. The battery of autonomic tests included R-R interval variation test, deep breathing, Valsalva manoeuvre, heart rate and blood pressure responses to standing, and sustained handgrip. Maximum conduction velocity along sensory and motor fibres of the posterior tibial nerve was measured. An impairment of parasympathetic reflexes was more frequent than a sympathetic damage, but with no relationship to the degree of electrophysiological disturbances. Cardiovascular autonomic dysfunction and somatic neuropathy in uraemia result to be two different entities in incidence and perhaps in pathogenesis.

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Cardiovascular-Reflex Testing and Single-Fiber Electromyography in Botulism

Cited by 61 publications

References 27 publications

Quantitative autonomic testing in the management of botulism

Quantitative autonomic testing in the management of botulism

Autonomic cardiovascular function and baroreflex sensitivity in patients with cervical dystonia receiving treatment with botulinum toxin type A

Comparative Analysis of Autonomic and Somatic Dysfunction in Chronic Uraemia

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