A 6-month-old boy with normal development developed constipation, poor feeding and lethargy, then drooping of the eyelids, weak cry, head lag and limb weakness. He had normal septic and metabolic work-up and neuroimaging studies. Myasthenia gravis (MG) and congenital myasthenic syndrome (CMS) were initially considered; pyridostigmine trial showed no improvement. Examination (figure 1, video 1) revealed an alert child with sluggishly reacting pupils, horizontal ophthalmoparesis, proximal limb weakness and preserved tendon reflexes. Infant botulism …

中文翻译：

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6 个月大的婴儿新发虚弱 - 考虑婴儿肉毒杆菌中毒

一名发育正常的6个月大男孩出现便秘、喂养不良和嗜睡，然后眼睑下垂、哭声无力、头落后、四肢无力。他进行了正常的脓毒症和代谢检查以及神经影像学检查。最初考虑重症肌无力（MG）和先天性肌无力综合征（CMS）；吡啶斯的明试验显示没有改善。检查（图 1，视频 1）显示一名警觉儿童，瞳孔反应迟缓、水平眼瘫、近端肢体无力和腱反射保留。婴儿肉毒杆菌中毒…