Botulism characterised by a) Seizure b) Fever c) Ascending paralysis d) Descending symmetrical paralysis e) Blurring of vision

**Core Concept**
Botulism is a rare but serious illness caused by **botulinum toxin**, produced by the bacterium *Clostridium botulinum*. This toxin affects the nervous system, leading to muscle weakness and paralysis. The clinical presentation of botulism is characterized by specific neurological symptoms.

**Why the Correct Answer is Right**
The correct answer is related to the typical presentation of botulism, which includes **descending symmetrical paralysis**. This condition starts with **blurring of vision**, followed by **dysphagia**, **dysarthria**, and eventually progresses to a symmetrical, descending pattern of paralysis. The toxin works by blocking the release of **acetylcholine**, a neurotransmitter responsible for muscle contraction, at the neuromuscular junction.

**Why Each Wrong Option is Incorrect**
**Option A:** Seizure is not a characteristic symptom of botulism. **Option B:** Fever is not typically associated with botulism. **Option C:** Ascending paralysis is more characteristic of **Guillain-Barré syndrome**.

**Clinical Pearl / High-Yield Fact**
A key point to remember is that botulism often presents with **cranial nerve palsies**, including **diplopia** (double vision) and **ptosis** (drooping eyelid), which are early signs of the illness.

**Correct Answer:** D. Descending symmetrical paralysis