Sir.—Johnson, Clay, and Arnon presented an excellent review of infant botulism in the Journal (133:586-593, 1979). In it, the authors mentioned that eight of their infants had electromyograms (EMGs) performed. On EMG, none showed enhancement of amplitude on repetitive stimulation (at 20 cps), although two of the four tested showed posttetanic facilitation.
In July 1978, we encountered two cases of infant botulism. Both were male, one was 1 month of age (case 1) and the other 5 months of age (case 2). Both first had constipation, followed in several days by hypotonia, paresis, ptosis and poor suck. Clostridium botulinum, type A, was grown from cultures of the stools of these infants. The infants made uneventful recoveries with supportive care. The EMGs were performed in case 1 on the 14th day after onset of weakness and in case 2 on the 15th day after onset of weakness. In both infants,