Role of Electrophysiology in Snake Envenomation Two Illustrative Cases
Abstract
Two patients of snakebite with neurotoxic symptoms were evaluated for understanding the neurophysiological manifestations of snake venom by electrophysiological testing. The testing revealed evidence of neuromuscular junction dysfunction in both cases with decremental response. This response was more evident on higher stimulation rates indicating a post-synaptic
defect distinctive from myasthenia gravis. EMG study in the first case provided a distinction between myokymia and fasciculations. Snake envenomation can often present as a myasthenic
syndrome with ambiguous history and in such cases electrophysiology can give a clue to the diagnosis.
References
1. Warrell DA Sanke bite. The Lancet. 2010; 375: 77-88
2. Kasturiratne A, Wickremasinghe AR, de Silva N et al. The Global Burden of Snakebite: A Literature Analysis and Modeling based on regional estimates of envenoming and deaths. PLos Med. 2008; 5:e218.
3. Simpson ID. A study of the current knowledge base in treating snake bite amongst doctors in the high-risk countries of India and Pakistan: does snake bite treatment training reflect local requirements? Trans R Soc Trop Med Hyg. 2008; 102:1108-14.
4. Whitaker R, Captain A. Snakes of India, the Field Guide. Chennai, India: Draco Books; 2004.
5. Seneviratne U, Dissanayake S. Neurological manifestations of snake bite in Sri Lanka. J Postgrad Med. 2002; 48:275
6. Saha A, Gomes A, Chakravarty AK et al. CNS and anticonvulsant activity of a non-protein toxin (KCMMTx) isolated from king cobra (Ophiophagus Hannah) venom. Toxicon. 2006; 47: 296-303
7. Sanmuganathan PS. Myasthenic syndrome of snake envenomation: a clinical and neurophysiological study. Postgrad Med J. 1998; 74:596-9.
2. Kasturiratne A, Wickremasinghe AR, de Silva N et al. The Global Burden of Snakebite: A Literature Analysis and Modeling based on regional estimates of envenoming and deaths. PLos Med. 2008; 5:e218.
3. Simpson ID. A study of the current knowledge base in treating snake bite amongst doctors in the high-risk countries of India and Pakistan: does snake bite treatment training reflect local requirements? Trans R Soc Trop Med Hyg. 2008; 102:1108-14.
4. Whitaker R, Captain A. Snakes of India, the Field Guide. Chennai, India: Draco Books; 2004.
5. Seneviratne U, Dissanayake S. Neurological manifestations of snake bite in Sri Lanka. J Postgrad Med. 2002; 48:275
6. Saha A, Gomes A, Chakravarty AK et al. CNS and anticonvulsant activity of a non-protein toxin (KCMMTx) isolated from king cobra (Ophiophagus Hannah) venom. Toxicon. 2006; 47: 296-303
7. Sanmuganathan PS. Myasthenic syndrome of snake envenomation: a clinical and neurophysiological study. Postgrad Med J. 1998; 74:596-9.
Published
2019-08-31
How to Cite
Gaurav Bhaskar Nigam, Babu S S , Sharma R , Peter C S, Sobhana. (2019). Role of Electrophysiology in Snake Envenomation Two Illustrative Cases. The Indian Practitioner, 68(2), 45-47. Retrieved from https://articles.theindianpractitioner.com/index.php/tip/article/view/679
Section
Case Reports
