botulinum

Botulinum typically refers to botulinum neurotoxins produced by the bacterium Clostridium botulinum and related species. These toxins are among the most potent known, and exposure can cause botulism, a life-threatening paralytic illness.

Botulinum neurotoxins are categorized into serotypes A through G, with A, B, and E most commonly implicated in human disease. They are zinc-dependent endopeptidases that cleave SNARE proteins, such as SNAP-25, syntaxin, and synaptobrevin, thereby inhibiting the release of acetylcholine at peripheral cholinergic synapses and causing flaccid paralysis.

Clostridium botulinum is an anaerobic, spore-forming bacterium found in soil, sediments, and untreated water. Botulism can result from ingestion of preformed toxin in improperly processed foods (foodborne botulism), wound contamination, or intestinal colonization by spores in infants (infant botulism). Honey is a known source of spores and is discouraged for children under one year.

Symptoms typically begin hours to days after exposure and include blurred or double vision, drooping eyelids, difficulty speaking or swallowing, dry mouth, and symmetrical descending weakness that may progress to respiratory failure.

Diagnosis is based on clinical presentation and laboratory confirmation of toxin in patient samples or implicated food. Treatment includes administration of botulinum antitoxin, wound debridement if needed, and supportive care such as airway management and mechanical ventilation.

Botulinum neurotoxins are also used in medicine in very small, controlled doses to treat conditions such as focal dystonias, spasticity, chronic migraine, excessive sweating, overactive bladder, and to reduce cosmetic wrinkles. These uses require professional administration and are subject to regulatory oversight.