Neurologists and the threat of bioterrorism.

摘要: Neurologists are most likely to become involved in primarily diagnosing those bioterrorist attacks utilising botulinum toxin. Oral ingestion, or possibly inhalation, routes of delivery. The characteristic descending paralysis starts the extraocular and bulbar muscles, with associated autonomic features. Repetitive nerve stimulation usually shows an incremental muscle response. Treatment is supportive. differential diagnosis from naturally occurring paralysing illnesses such as Guillain-Barre syndrome, myasthenic crisis diphtheria, seafood neurotoxins (tetrodotoxin, saxitoxin), snake envenomation, chemical warfare poisoning by organophosphates. Primary neurological infections less feasible for use bioweapons. There theoretical possibilities Venezuelan equine encephalitis transmission inhalation secondary zoonotic cycles sustained horses mosquitoes. Severe haemorrhagic meningitis regularly occurs anthrax, aftermath severe systemic disease have been transmitted spore inhalation. Panic psychologically determined 'me-too' symptomatology pose biggest diagnostic management burden on neurologists handling attack institution a random civilian population. Indeed panic disablement institutional operations be prominent intentions any attack.