Acute onset areflexic quadriparesis with blurred vision and absent pupillary response in a 20 years old male, the most probable diagnosis is?
Porphyria
Botulism
Polio
Diphtheria
ANSWER: (B) BotulismREF: Harrison s 17th ed p. 901, CMDT - 2006/1410The clinical picture is most consistent with diagnosis of botulismBotulismh/o recent injection of canned or smoked foods or injection of drugSymmetric descending paralysis with prominent bulbar palsyDiplopia , dysarthria , dysphonia , dysphagiaPupils are fixed and dilatedPtosis and cranial nerve palsy with impairment of extra ocular muscles and fixed dilated pupils are characteristic signsSensory examination is normalNormal sensoriumAfebrile
Toxicology