This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Chan, T Y. Articles by Kwok, T C. Search for Related Content PubMed PubMed Citation Articles by Chan, T Y. Articles by Kwok, T C. Social Bookmarking                   What's this?

Chronicity of neurological features in ciguatera fish poisoning

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 9/F Clinical Sciences Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China

T CY Kwok

Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China

A 43-year-old woman complained of colicky abdominal pain, followed by numbness, myalgias, and muscle weakness in the four limbs after eating a grouper (Epinepheius spp.). She presented to our hospital 36 hours later with increased myalgias, muscle weakness, and malaise. On examination, the muscle power and sensation in her four limbs appeared to be normal. She was given an intravenous infusion of mannitol 20% (200 ml over 1 hour) and an intramuscularinjection ofdiclofenac (75mg).Hermyalgias then improved andshe was discharged. She presented to our hospital again 1 week later with poor appetite, malaise, numbnessofthefourlimbs,andincreasedmuscleweakness. On examination, the muscle weakness was more marked in the lower limbs (4⁺/5) than in the upper limbs (5 /5) and proximally than distally. She also had some difficulty in getting up from a squatting position. She was given another intravenous infusion of mannitol 20% (200 ml over 1 hour), following which there was subjectively slight improvement inhermuscleweakness.Herplasmacreatinephosphokinase level was normal. Electromyography performed 4 weeks later revealed no abnormalities. When she was reviewed 45 days after the consumption of the grouper, her muscle weakness and malaise had improved considerably. She could then stand up from a squatting position. However, mild impairment of finger grip was still present. Chronicity of neurological features in other reported cases (e.g., chronic fatigue, relapse of symptoms after exposure to ciguateric fish or alcohol, and peripheral neuropathy) may also indicate a lengthy persistence of ciguatoxins in the body.

Key Words: ciguatera • fish poisoning • neurotoxicity • ciguatoxins • myopathy

Human & Experimental Toxicology, Vol. 20, No. 8, 426-428 (2001)
DOI: 10.1191/096032701682692928


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				M.-L. Chateau-Degat, A. Beuter, G. Vauterin, N. L. Nguyen, M. Chinain, T. Darius, A.-M. Legrand, R. Chansin, and E. Dewailly Neurologic Signs of Ciguatera Disease: Evidence of their Persistence Am J Trop Med Hyg, December 1, 2007; 77(6): 1170 - 1175. [Abstract] [Full Text] [PDF]