Lance-Adams syndrome: An unusual complication of snakebite envenomation

Neuroparalytic snakebite envenomation is common in tropics and sub-tropics. The clinical history is sometimes unclear and misleading, leading to delay in diagnosis and initiation of life-saving treatments. It often gets so delayed that the patient may end up in neuromuscular respiratory failure. If sustained hypoxia occurs, a permanent neurological squeal may be the endpoint. We report a novel case of a 21-year-old previously healthy young Indian man who had a rapidly progressive neuroparalytic respiratory failure following a cobra bite for which he required mechanical ventilation for four days. After weaning successfully from the ventilator, he developed Lance-Adams syndrome, which persisted for over a month and eventually responded well to medical treatment.