Botulism differential diagnosis

Overview
Physicians may consider the diagnosis if the patient's history and physical examination suggest botulism. However, these clues are often not enough to allow a diagnosis of botulism. Other diseases such as the following can appear similar to botulism, and special tests may be needed to exclude these other conditions. These tests may include:
 * Guillain-Barré syndrome
 * Stroke
 * Myasthenia gravis
 * Brain scan
 * Cerebrospinal fluid examination
 * Nerve conduction test (electromyography, or EMG)
 * Edrophonium Chloride (Tensilon) test for myasthenia gravis.

The most direct way to confirm the diagnosis is to demonstrate the botulinum toxin in the patient's serum or stool by injecting serum or stool into mice and looking for signs of botulism that can be blocked by specific antisera.