• descending flaccid paralysis all muscles 2 to 48hrs following ingestion of the botulinum toxin (exotoxin of Clostridium botulinum) – usually ingested from improperly prepared canned or bottled foods (spores are not destroyed during preparation)
• toxin acts on presynaptic mechanism that release acetylcholine
• nausea, vomiting and diarrhoea may precede paralysis
• course depends on amount of toxin - can progress to quadriplegia or death if severe; if small amount of toxin  mild symptoms and may get complete recovery
• generally need admission to intensive care facility; antitoxins

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