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Neurological complications secondary to severe scorpion envenomation
Mabrouk Bahloul1, Noureddine Rekik, Imen Chabchoub
1Service de Réanimation Médicale, CHU Habib Bourguiba, Sfax, Tunisia. bahloulmab@yahoo.fr
Background:
The aim was to study the incidence, clinical manifestations, and prognosis of neurological complications secondary to scorpion envenomation.
Material/Methods:
A retrospective study over a 13-year period including all patients admitted to our ICU for scorpion envenomation.
Results:
During the period of study, 951 patients were admitted due to scorpion envenomation. Mean age was 14.7+/-17.4 years, ranging from 0.5 to 90 years. Neuromuscular signs were observed in 739 patients (78%), coma (Glasgow Coma Score 12) in 15.4% of cases, and convulsions in 6%. The other neurological signs observed were: agitation in 709 patients (74.6%), squint in 119 patients (12.5%), bilateral miosis in 43 patients (5%), and a bilateral mydriasis in 16 patients (1.7%). Brain CT was performed in 10 patients, these being abnormal in 90% of cases. In our study the presence of coma (p<0.001), convulsions (p<0.001), bilateral miosis (P<0.001), and the presence of bilateral mydriasis (P<0.001) correlated with poor outcome.
Conclusions:
Neurological manifestations were often observed in severe scorpion-envenomed patients and they correlated with poor outcome. Their mechanisms are complex. Prevention is highly warranted.
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