Journal de toxicologie clinique
Libre accès

Abstrait

Neurotoxic Manifestation of Snake Bite in Bangladesh

Mohammad Robed Amin, SM Hasan Mamun, Nazmul Hasan Chowdhury, M Rahman, Mohammad Ali, Abdullah Al Hasan, MR Rahman and M A Faiz

Introduction: Snake bite is a potentially life threatening emergency situation physician has to encounter in rural areas of tropical countries in South-East Asia including Bangladesh. Among the venomous snakes in Bangladesh, Neurotoxic snakes like Cobra and Krait are the commonest. In this study neurotoxic manifestation of venomous snakes are clinically observed.

Methods: In this series a total 35 snakebite patients with neurological features from May 1999 to June 2001 were included and preexisting neurological cases were excluded.

Results: Among the 537 total snake bite cases, the neurotoxic snake bite was 10% with 51 cobra bite and 12 kraits bite. The victims age are in the range of 3.5 years to 85 years with 70% cases are under 30 years of old. There is slight male preponderence with almost same number of bite at home and outside. The common clinical neurotoxic features are ptosis, (100%) external ophthalmoplegia, dysphagia, dysphonia and broken neck sign. The chest movements were reduced in 20 % cases. All 35 cases (100%) were treated with Haffkine polyvalent anti snake venom with 8.6% cases needed 2nd dose. All 35 cases with neurotoxic features were also treated with anti cholinesterses (100%) and among them 14.2% needed ventilatory support. Anti-snake venom reaction was very common in the with pyrogenic reaction (80.64%) and anaphylactic reaction (64.51%). The outcome of snake bite was excellent with 97% recovery with one residual neurological deficit and no fatality.

Conclusion: The neurotoxic snake bite has definite characteristics neurological sign and symptoms which could lead to fatality with respiratory paralysis.