Neuroparalytic syndrome encountered with snake bite poisoning

Area of Science:

• Neuroscience
• Toxicology
• Clinical Medicine

Background:

• Neuroparalytic manifestations present a diagnostic challenge, particularly when the etiology is unclear.
• Elapid snakebites are a significant cause of neurotoxicity and paralysis in endemic regions.

Purpose of the Study:

• To investigate the clinical features and outcomes of neuroparalysis in patients presenting with various neurological deficits.
• To evaluate the effectiveness of antivenom therapy and supportive care in managing neuroparalysis, especially following suspected elapid envenomation.

Main Methods:

• A retrospective study of 37 patients with neuroparalytic manifestations.
• Clinical assessment of neurological deficits, including drowsiness, stupor, coma, ptosis, ophthalmoplegia, and paralysis.
• Treatment involved respiratory support, antivenom serum, and atropine-neostigmine combination.

Main Results:

• 25 patients had a history of snake bite, while 12 presented with unexplained morning unresponsiveness.
• Neurological deficits included ptosis (22), ophthalmoplegia (12), pharyngeal paralysis (12), and limb paralysis (16).
• Dramatic recovery occurred in 25 patients; 6 died within 12 hours, and 6 showed gradual improvement.

Conclusions:

• A high index of suspicion is crucial for the early diagnosis of elapid bite poisoning as a cause of neuroparalysis.
• Prompt administration of antivenom serum and appropriate supportive care can significantly improve outcomes in neuroparalysis.
• Early recognition and management are key to reducing mortality and morbidity associated with neurotoxic envenomation.