Ciguatera fish poisoning: treatment with intravenous mannitol

Intravenous mannitol was given to 16 patients with acute ciguatera fish poisoning requiring hospital admission. Thirteen patients (81%) presented with sensory and neuromuscular symptoms; paraesthesiae and pain and weakness in the lower limbs were predominant features. Mannitol had little effect upon gastrointestinal manifestations, but a marked reduction was observed in the expected duration of neurological symptoms. Although these results are empirical and uncontrolled, they suggest that mannitol infusion may be effective in altering the clinical course of acute ciguatera fish poisoning.