Botulism poisoning is caused by a neurotoxin produced by the bacterium Clostridium botulinum. The toxin prevents release of ACh from the terminal boutons of somatic motor axons. Without prompt treatment with an antitoxin, death may result from paralysis of breathing muscles. Poisoning results from eating improperly canned vegetables or meats that contain C. botulinum and the accumulated toxins.

Myasthenia gravis is characterized by extreme muscular weakness caused by improper functioning of the neuromuscular junctions. It is an autoimmune disease in which antibodies are produced that attach to the ACh receptors on the motor end plate and reduce or block the stimulatory effect of ACh. Myasthenia gravis occurs most frequently in women between 20 and 40 years of age. Usually, it first affects ocular muscles and other muscles of the face and neck, which may lead to difficulty in chewing, swallowing, and talking. Other muscles of the body may be involved later. Treatment typically involves the use of acetylcholinesterase inhibitors and immunosuppressive drugs, such as the steroid prednisone.

Poliomyelitis is a viral disease of somatic motor neurons in the spinal cord. Destruction of the somatic motor neurons leads to paralysis of skeletal muscles. It is now rare in industrialized countries due to the availability of a polio vaccine. Virtually all children in the United States receive this vaccine, which protects them from polio.

Spasms are sudden, involuntary contractions of a muscle or a group of muscles. They may vary from simple twitches to severe convulsions and may be accompanied by pain. Spasms may be caused by irritation of the motor neurons supplying the muscle, emotional stress, or neurological disorders. Spasms of smooth muscle in the walls of the digestive and respiratory tracts, or certain blood vessels can be hazardous. Hiccupping is a spasm of the diaphragm.

Tetanus (tet ‘-ah-nus) is a disease caused by the anaerobic bacterium Clostridium tetani, which is common in soil. Infection usually results from puncture wounds. C. tetani produces a neurotoxin that affects somatic motor neurons in the spinal cord, resulting in continuous stimulation and tetany of certain muscles. Because the first muscles affected are those that move the mandible, this disease is often called “lockjaw.” Without prompt treatment, mortality is high. Young children usually receive vaccinations of tetanus toxoid to stimulate production of antibodies against the neurotoxin. Booster injections are given at regular intervals to keep the concentration of antibodies at a high level in order to prevent the disease.