Acute onset of blurred vision and absent pupillary response with rapidly progressive descending muscular weakness manifesting as quadriparesis in an afebrile 20 year old male with preserved sensorium is -
Porphyria
Botulism
Polio
Diphtheria
Ans. is tb' i.e., Botulism Remember these important points about Botulismo Acute onset of weakness in muscles innervated by cranial nerve with prominent bulbar palsy (4D's) i.e. -# Diplopia# Dysphonia# Dysphagia# Dysarthriao Descending symmetrical weakness occurs often leading to weakness,o Sensory' abnormalities are absent because only motor and autonomic nerves affected.o Mental function not affected o Afebrileo Absent pupillaty reflexes
Toxicology