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Comparative study of electrophysiological changes in snake bites.
Patwari Panduranga1, S A Sangle, Abhay A Mane
1Department of Medicine, BJ Medical College and Sassoon General Hospital, Pune, Maharashtra, India.
Neurology India
|June 9, 2015
Summary
Electrophysiological studies reveal decremental responses on repetitive nerve stimulation (RNS) in both neuroparalytic and vasculotoxic snakebites. This finding indicates neuromuscular blockade can occur in both types of envenomation, challenging previous distinctions.
Area of Science:
- Neurology
- Toxicology
- Electrophysiology
Background:
- Snakebites present diverse clinical syndromes, including neuroparalytic and vasculotoxic effects.
- Differentiating the electrophysiological underpinnings of these syndromes is crucial for accurate diagnosis and management.
Purpose of the Study:
- To compare electrophysiological changes in patients with neuroparalytic versus vasculotoxic snakebites.
- To investigate the presence and characteristics of neuromuscular blockade in both types of envenomation.
Main Methods:
- A comparative study involving 40 patients with confirmed neuroparalytic (Group A) or vasculotoxic (Group B) snakebites.
- Standard clinical examinations, relevant investigations, and nerve conduction studies, including repetitive nerve stimulation (RNS) and post-exercise studies.
Main Results:
- Motor nerve conduction parameters remained within normal limits in both groups.
- Decremental responses on RNS were observed in facial and median nerves in both neuroparalytic and vasculotoxic snakebite groups, though with varying frequencies.
- Post-exercise decremental responses were also noted in both groups, particularly in the facial nerve.
Conclusions:
- Repetitive nerve stimulation (RNS) demonstrates decremental responses in both neuroparalytic (post-synaptic blockade) and vasculotoxic snakebites (pre-synaptic blockade).
- These electrophysiological findings suggest that neuromuscular blockade is a feature present in both types of snake envenomation, necessitating a broader diagnostic consideration.
