Initial symptoms of wound botulism include:

• Change in vision:
• Double vision
• Dry mouth
• Difficulty speaking
• Weakness or fatigue
• Wound pain

Symptoms of muscle weakness caused by botulism start in the face and neck, spread to both arms, and then to both legs. The muscles that control swallowing and breathing may also become weak.

Symptoms of muscle weakness include:

• Facial weakness
• Arm weakness (bilateral)
• Leg weakness (bilateral)
• Difficulty swallowing
• Difficulty breathing

Additional symptoms may include:

• Nausea
• Vomiting
• Constipation
• Abdominal pain
• Sore throat