Neuroparalysis due to envenomation by common cobra (Naja naja) and common krait (Bungarus caeruleus) is a common life-threatening medical emergency in India (1).
A brief review of the clinical profile of and outcomes in patients with snake bite leading to neuroparalysis as well as AD leading to HTN is presented in Table 1 (2-9).
History revealed that the patient was admitted in the Government Medical College in view of neuroparalysis
secondary to snake bite.
Especially, in acute reversible conditions like snake bites with neuroparalysis
and other poisoning it is highly gratifying to emergency physicians.
By inhibiting the release of acetylcholine at the NMJ, neuroparalysis
and denervation of the involved muscles occur, which decreases the ability of the muscles to generate force [79, 80].
The apamin has been implicated in the development of ophthalmoplegia (secondary to neuroparalysis
of the third cranial nerve), iridoplegia, optic neuritis, papilledema and optic atrophy (2).
The cow had difficulty in walking Tuesday, a symptom of BSE, and was diagnosed as suffering symptoms of neuroparalysis
in its left foreleg.
When botulism is suggested by clinical manifestations, (e.g., descending neuroparalysis
, ptosis, and extraocular palsies), physicians should obtain a thorough food history to assist in the diagnosis and in identifying and obtaining potentially contaminated leftover food.
Study parameters were detailed history, site of bite, indoor or outdoor bite, type of snake if known, clinical features of signs of neurotoxic, haemotoxic and or local envenomation, bleeding either from the bite site or from any other site, swelling at the site of bite, ptosis, respiratory difficulty, neuroparalysis
in the form of weakness of limbs, trunk, head lag, hypotonia, dysphagia, diplopia, drooling of saliva, dysgeusia, altered sensorium, vital signs on admission, pupillary size, pupillary reaction, extraocular movements, hypotonia, absent reflexes, pre-hospital therapy, time interval from bite to hospital admission, time interval from bite to administration of ASV.
2 patients had both haemotoxicity and neurotoxicity while 3 had predominantly neuroparalysis
and respiratory failure.