Mild ciguatera poisoning: Case reports with neurophysiological evaluations

Area of Science:

• Toxicology
• Neuroscience
• Clinical Neurology

Background:

• Ciguatera poisoning is a significant marine neurotoxic illness.
• It primarily manifests with gastrointestinal and neurological symptoms, including peripheral neuropathy and altered thermal sensation.
• Electrophysiological studies in ciguatera poisoning are typically normal, except in severe presentations.

Observation:

• Four individuals experienced mild ciguatera poisoning following barracuda consumption.
• Despite mild symptoms, electrophysiological assessments were performed.
• These assessments identified normocalcemic latent tetany in the affected individuals.

Findings:

• The observed latent tetany is consistent with the known mechanism of ciguatoxin.
• Ciguatoxin is understood to inactivate voltage-gated sodium channels.
• This inactivation leads to increased nerve membrane excitability.

Implications:

• This study highlights that electrophysiological abnormalities, such as latent tetany, can occur even in mild ciguatera poisoning.
• The findings reinforce the neurotoxic mechanism of ciguatoxin involving sodium channel function.
• Understanding these electrophysiological changes aids in diagnosing and managing ciguatera poisoning, even in less severe cases.