Case 1: A 20-year-old man presented with a history of diffuse abdominal pain, myalgias, difficulty in swallowing, and pooling of secretions. He also complained of difficulty in breathing and diplopia with acute onset drooping of eyes. He was conscious, and oriented to time and space, with a respiratory rate of 12/min and a single breath count of 12. The power in all limbs was 4/5, but all reflexes were absent. He had ptosis, and the rest of the general and systemic examination was normal. He was absolutely normal the previous night when he had slept on the floor.