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Neurotoxic marine poisoning
Geoffrey K Isbister1, Matthew C Kiernan
1Tropical Toxicology Unit, Menzies School of Health Research, Charles Darwin University, NT, and Department of Clinical Toxicology and Pharmacology, Newcastle Mater Misericordiae Hospital, NSW, Australia. gsbite@ferntree.com
The Lancet. Neurology
|March 22, 2005
Summary
Marine animal ingestion can cause poisoning with neurological symptoms. Ciguatera is common with GI and neurological effects, while tetrodotoxin and paralytic shellfish poisoning are rarer but more fatal, causing paralysis.
Area of Science:
- Marine Biology
- Toxicology
- Neurology
Background:
- Marine poisoning, caused by consuming toxic marine animals, leads to significant health issues, particularly in coastal areas.
- Three primary syndromes—ciguatera, tetrodotoxin poisoning, and paralytic shellfish poisoning—are notable for their neurological manifestations.
Purpose of the Study:
- To review the clinical features, diagnosis, and treatment of major marine poisoning syndromes.
- To differentiate between ciguatera, tetrodotoxin poisoning, and paralytic shellfish poisoning based on their distinct characteristics and severity.
Main Methods:
- Review of existing literature on marine poisoning syndromes.
- Analysis of clinical presentations, diagnostic criteria, and treatment strategies.
Main Results:
- Ciguatera poisoning is the most frequent, presenting with gastrointestinal and neurological symptoms but rarely causing death.
- Tetrodotoxin and paralytic shellfish poisoning are less common but more lethal, characterized by mild gastrointestinal issues and rapidly progressing descending paralysis, potentially leading to respiratory failure.
- Diagnosis relies on ingestion history and clinical effects, with no specific antidotes available.
Conclusions:
- Supportive care, including mechanical ventilation for severe paralysis, is the primary treatment for marine poisoning.
- Understanding the distinct syndromes is crucial for timely diagnosis and management of potentially fatal marine-induced toxicities.