Food poisoning by botulinum toxin
In Germany there are about 20 to 40 cases of poisoning by botulinum toxin (Botox®) per year, which one or two patients do not survive. The first signs of poisoning appear after about 12 to 40 hours and usually affect the eye muscles first, which is why the patient sees double images. Later on, swallowing and speech disorders, headaches and nausea occur.
In this condition the poisoning can still be treated with an antitoxin, which aims to remove the poison from the digestive tract. If the treatment is not carried out or is carried out too late, the paralysis of the heart and respiratory muscles results in death by cardiac arrest or suffocation. The bacterium causing the poisoning, Clostridium botulinum, needs an environment without oxygen, which is weakly acidic or neutral and offers a pronounced nutrient supply in order to survive and form its toxin.
Canned meat or fish are therefore particularly at risk. The formation of the toxin can be avoided by curing the meat, as the nitrite it contains inhibits the growth of the bacterium. Before eating canned food, one should therefore check whether there are any signs that it is poisoned.
This can be indicated by a convex lid of a can, for example, or by gases escaping when opening it, which usually smell bad. If you are not sure whether one of these signs is true, you can protect yourself by boiling the contents of the tin can for a few minutes, as the protein botulinum toxin (Botox®) becomes ineffective. In neurology, the active ingredient botulinum toxin (Botox®) is used in diseases that lead to increased muscle activity in patients.
It has the ability to relieve spasms of the eyelids (blepharospasms), hemiplegic spasms of the facial muscles (hemifacial spasms) and tension in the neck area (torticollis spasmodicus; cervical dystonia). It is also used to relieve muscle tension caused by the brain (focal dystonia). These include spastic paralysis or tetra-spasticity in children (a condition often associated with a spastic toe) or spasticity of the hands and/or wrists that can occur after a stroke.
Botox® can also be used to inhibit excessive perspiration (hyperhidrosis), but only if it is very pronounced and has a significant impact on the patient’s daily life and cannot be controlled by local treatment. Other areas of application are the treatment of strabismus, tension headaches and migraines, increased salivary production and oesophageal constrictions. Generally, muscle paralysis occurs about two to three days after the injection and reaches its maximum effect after about five to six weeks. In order to regain intact muscle function, the nerve endings have to grow back, which takes about 12 weeks on average; the effect of the nerve toxin therefore lasts for this period. However, if injected under the skin (in the treatment against increased sweating), the effect can last for more than a year.
