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Case report: acute demyelinating encephalomyelitis following viper bite.

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Summary

Acute demyelinating encephalomyelitis (ADEM) is a rare central nervous system complication following Deinagkistrodon viper bites. Prompt diagnosis with MRI and corticosteroid treatment led to patient recovery.

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Area of Science:

  • Neurology
  • Toxicology
  • Demyelinating Diseases

Background:

  • Central nervous system complications of venomous snakebites typically include intracranial hemorrhage and ischemic stroke.
  • Acute demyelinating encephalomyelitis (ADEM) is a rare neurological complication following snake envenomation.

Observation:

  • A 50-year-old male developed ADEM after a Deinagkistrodon viper bite, presenting with a 14-day period of unconsciousness.
  • Magnetic resonance imaging (MRI) of the brain indicated ADEM.
  • The patient received tetanus toxoid and polyvalent antisnake venom for the envenomation.

Findings:

  • High-dose methylprednisolone therapy was administered as a diagnostic and therapeutic measure.
  • The patient exhibited rapid clinical improvement following corticosteroid administration.
  • ADEM can be triggered by either the snake venom itself or the administered antivenin.

Implications:

  • This case highlights ADEM as a potential, albeit rare, neurological sequela of Deinagkistrodon viper bites.
  • Early diagnosis of ADEM is facilitated by MRI.
  • High-dose corticosteroid therapy demonstrates efficacy in managing ADEM post-viper bite or antivenin treatment.