Acute paralysis after seafood ingestion

Area of Science:

• Marine Biology
• Toxicology
• Neuroscience

Background:

• Tetrodotoxin (TTX) is a potent neurotoxin commonly found in pufferfish.
• Shellfish, particularly trumpet shellfish from the Atlantic, can accumulate TTX through their diet.
• Marine toxin ingestion poses a significant public health risk, especially in regions with seafood consumption.

Observation:

• A patient in Southern Europe ingested trumpet shellfish from the Atlantic Ocean.
• The patient presented with acute generalized paralysis and respiratory failure, requiring mechanical ventilation.
• Initial neurophysiological assessments revealed complete peripheral nerve inexcitability and normal electroencephalography (EEG).

Findings:

• High concentrations of tetrodotoxin (TTX) were confirmed in the patient's blood and urine via high-performance liquid chromatography-mass spectrometry (HPLC-MS).
• The patient demonstrated a remarkable clinical recovery, regaining normal strength, reflexes, and sensation within 72 hours of hospital admission.
• This case highlights the potential for severe neurotoxicity from TTX-contaminated shellfish in European waters.

Implications:

• This case underscores the importance of monitoring shellfish for tetrodotoxin contamination in European waters.
• Early recognition and supportive care, including mechanical ventilation, are crucial for managing severe TTX intoxication.
• Further research into the prevalence and sources of TTX in European marine ecosystems is warranted to prevent future intoxications.