Botulism and tetanus
The toxin released by Clostridium botulinum also works at the NMJ by blocking acetylcholine release. Exposure leads to an acute-onset descending flaccid paralysis.
Tetanus toxin also binds to the NMJ but is transported up the neuron to the CNS where it blocks neurotransmitter release from spinal inhibitory interneurons, thereby causing a spastic rather than flaccid paralysis.
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