<prompt> An 18 year old male presented with acute onset descending paralysis of 3 days duration. There is also a history of blurring of vision for the same duration. On examination, the patient has quadriparesis with areflexia. Both the pupils are non-reactive. The most probable diagnosis is:PoliomyelitisBotulismDiphtheriaPorphyria  <response>: Diagnosis of botulism should be considered in patient with symmetric descending paralysis with bilateral cranial neuropathies in addition of following features:Absent feverPatient remains responsiveHeart rate normal or slowSensory deficit doesnt occur except for blurred vision.Remember: Neurologic signs and symptom of botulism:DysphagiaDry mouthDiplopiaDysarthriaUpper limb weaknessLower limb weaknessBlurred visionDyspnea 