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Role of Electrophysiology in Snake Envenomation Two Illustrative Cases


Affiliations
1 Department of Medicine, St Stephen's Hospital, Tis Hazari, New Delhi, India
2 Department of Neurology, St Stephen's Hospital, Tis Hazari, New Delhi, India
3 Metropolis Labs, Allapuzha, Kerala, India
     

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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.
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  • Role of Electrophysiology in Snake Envenomation Two Illustrative Cases

Abstract Views: 272  |  PDF Views: 0

Authors

G. B. Nigam
Department of Medicine, St Stephen's Hospital, Tis Hazari, New Delhi, India
S. S. Babu
Department of Neurology, St Stephen's Hospital, Tis Hazari, New Delhi, India
R. Sharma
Department of Medicine, St Stephen's Hospital, Tis Hazari, New Delhi, India
C. S. Peter
Metropolis Labs, Allapuzha, Kerala, India
Sobhana
Metropolis Labs, Allapuzha, Kerala, India

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.