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Locked-in syndrome in snakebite.

S Prakash¹, C Mathew, S Bhagat

¹Department of Neurology, Medical College, Baroda, Gujarat.

The Journal of the Association of Physicians of India

|May 14, 2008

Summary

This summary is machine-generated.

Two patients recovered from locked-in syndrome (LIS) after snakebites. Prompt polyvalent anti-snake venom (ASV) treatment is crucial for suspected elapid bites presenting with LIS, differentiating it from coma.

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Area of Science:

Neurology
Toxicology
Herpetology

Background:

Locked-in syndrome (LIS) is a rare neurological condition characterized by complete paralysis while maintaining consciousness.
Snakebites are a significant health concern, particularly in endemic regions, with neurotoxic envenomation posing a severe threat.
Early recognition and prompt treatment are critical for improving outcomes in neurotoxic snakebite victims.

Observation:

Two pediatric cases of locked-in syndrome (LIS) following presumed snakebites are presented.
The first patient presented with LIS and showed a complete response to polyvalent anti-snake venom (ASV).
The second patient presented in a complete LIS state with rapid onset of ophthalmoplegia, bulbar symptoms, and quadriparesis six hours post-snakebite.

Findings:

Complete recovery from LIS was achieved in both patients following ASV administration.
The findings suggest that elapid snakebite should be considered in unresponsive patients presenting in the early morning in endemic areas during the monsoon season.
Successful ASV treatment in the second patient underscores the importance of distinguishing LIS from coma and brain death in snakebite cases.

Implications:

This study highlights the potential for complete recovery from LIS in snakebite victims with timely and appropriate ASV treatment.
It emphasizes the need for heightened clinical suspicion for neurotoxic elapid snakebites, especially in specific environmental and temporal contexts.
Differentiating LIS from coma in snakebite patients is critical, as LIS carries a favorable prognosis with effective antivenom therapy.