Neurophysiological findings in patients 1 year after snake bite-induced neurotoxicity in Sri Lanka

Bell, David J., Wijegunasinghe, D., Samarakoon, S., Palipana, H., Gunasekera, S., de Silva, H.A., Lalloo, David ORCID: https://orcid.org/0000-0001-7680-2200, Ranawaka, U.K. and de Silva, H.J. (2010) 'Neurophysiological findings in patients 1 year after snake bite-induced neurotoxicity in Sri Lanka'. Transactions of The Royal Society of Tropical Medicine and Hygiene, pp. 351-356.

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Abstract

Snake bite causes significant morbidity and mortality in Sri Lanka. Snake venoms contain
neurotoxins that block neuromuscular junction transmission. Pre-synaptic neurotoxicity
most commonly causes destruction of nerve terminals with recovery by re-growth, whilst
post-synaptic neurotoxicity usually involves competition at the acetylcholine receptor.
The aim of this study was to investigate whether there were long-term clinical or neurophysiological
changes in snake bite survivors 1 year after their envenoming. Detailed
neurophysiological tests and clinical examinations were performed on 26 snake bite victims
who had presented with neurotoxicity 12 months previously, and their results were
compared with controls recruited from the same communities. Significant differences were
observed in some nerve conduction parameters in some snake bite cases compared with
controls, predominantly in those thought to be due to elapid bites, including prolongation
of sensory, motor and F-wave latencies and reduction of conduction velocities. There was
no evidence of any residual deficits in neuromuscular junction transmission. These results
suggest a possible demyelinating type polyneuropathy. None of the cases or controls had
abnormalities on clinical examination. This is one of the few studies to report possible
long-term neurological damage following systemic neurotoxicity after snake bite. The clinical
significance of these neurophysiological abnormalities is uncertain and further studies
are required to investigate whether the abnormalities persist and to see whether clinical
consequences develop.

Item Type:	Article
Additional Information:	Definitive version available at: http://www.sciencedirect.com/science/article/B75GP-4Y71918-1/2/a49bb35b9b22d339d8612bbea9014311
Uncontrolled Keywords:	Snake bite; Venom; Neurotoxicity; Neurophysiology; Demyelination; Electromyography
Subjects:	WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Animal Poisons > WD 410 Reptiles
Faculty: Department:	Groups (2002 - 2012) > Clinical Group
Digital Object Identifer (DOI):	https://doi.org/10.1016/j.trstmh.2009.12.003
Depositing User:	Users 43 not found.
Date Deposited:	15 Jul 2010 13:16
Last Modified:	06 Feb 2018 13:00
URI:	https://archive.lstmed.ac.uk/id/eprint/1045

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