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Electroencephalographic abnormalities in patients with snake bites

S Ramachandran1, B Ganaikabahu, K Pushparajan

  • 1Medical Unit, General Hospital, Colombo, Sri Lanka.

The American Journal of Tropical Medicine and Hygiene
|January 1, 1995
PubMed
Summary

Electroencephalograms (EEGs) revealed significant brain impact in 96% of snakebite patients. These EEG changes, indicating encephalopathy, occurred rapidly and across various snake species, even without clinical neurological symptoms.

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Area of Science:

  • Neuroscience
  • Toxicology
  • Clinical Neurology

Background:

  • Snakebite envenomation poses a significant global health threat.
  • The neurotoxic effects of snake venom can lead to varied clinical presentations.
  • Cerebral involvement in snakebite patients requires further investigation.

Purpose of the Study:

  • To investigate the cerebral impact of snake venom using electroencephalograms (EEGs).
  • To characterize EEG abnormalities in patients with snakebite across different snake species.
  • To determine the correlation between EEG findings and clinical outcomes.

Main Methods:

  • Obtained electroencephalograms (EEGs) from 26 patients diagnosed with snakebite.
  • Identified snake species involved in envenomation (Russell's viper, cobra, hump-nosed viper, dog-faced water snake).

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  • Classified EEG abnormalities into three grades based on severity (Grade 1, 2, 3).

    • Main Results:

    • 96% of patients exhibited abnormal EEGs, irrespective of snake species.
    • Common abnormalities included reduced alpha activity, increased theta/beta activity, sharp waves, spikes, and diffuse delta activity.
    • Moderately severe to severe EEG abnormalities (Grade 2 and 3) were observed in 35% of patients.
    • EEG changes, suggestive of encephalopathy, appeared within hours and persisted for days, primarily affecting the temporal lobe.
    • Similar EEG alterations were noted in patients with and without antivenom therapy, and in those with concurrent renal or electrolyte imbalances.

    Conclusions:

    • Snake venom significantly impacts cerebral function, manifesting as encephalopathy detectable by EEG.
    • EEG abnormalities are a common and early consequence of diverse snakebite envenomations.
    • The observed EEG changes appear to be a direct effect of venom on the brain, independent of clinical neurological status or antivenom treatment.