Ciguatera poisoning

Achaibar, K. C; Moore, S.; Bain, Peter G.

doi:10.1136/jnnp.2007.129049

Cited by 27 publications

(20 citation statements)

References 30 publications

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“…Ciguatera is a marine food poisoning caused by the ingestion of fish contaminated with ciguatoxin 1 2. Diagnosis of ciguatera poisoning remains clinical, based on history and exclusion.…”

Section: Discussionmentioning

confidence: 99%

“…The proposed mechanism reported in previous experimental studies was to bind to and open voltage-gated sensitive Na + channels at resting membrane potential, resulting in neural hyperexcitability. Followed by continuous Na + influx, cells become swollen because water enters the cell throughout the effect to maintain the osmotic equilibrium between intra- and extracellular space 1 3. The mechanism was proven partially by the finding of the sural nerve oedema on biopsy 4…”

Section: Discussionmentioning

confidence: 99%

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Reversible corpus callosum lesion in ciguatera poisoning

et al. 2009

Journal of Neurology, Neurosurgery & Psychiatry

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A 45-year-old woman presented with profound watery diarrhoea, abdominal cramp and vomiting, followed by dysthesiae and paraesthesiae, generalised myalgia, retro-orbital pain and generalised pruritus approximately several hours after eating the internal organs of Sphyraena barracuda. She denied a past history of medical disease, surgery, trauma, medication use, or allergy to drugs or food. Moreover, her elder sister (51 years old), brother-in-law (59 years old) and son (25 years old) also complained of similar but less severe symptoms after eating the internal organ of S barracuda 2 weeks ago. The neurological examination disclosed clear consciousness, intact cranial nerve function and well muscle strength. The neuropsychological examination of the patient did not show callosal syndrome, for example, hemialexia, unilateral agraphia, unilateral agnosia and unilateral apraxia, too. The peripheral nervous system evaluation revealed ''cold reversal'' (reverse cold as burning, tingling or unbearable heat) manifestation, mild impairment of vibration and position sensations and generalised hyporeflexia. A brain MRI, done 4 days after the date of admission, revealed the presence of hyperintensity of corpus callosum on T2-weighted and fluid attenuation inversion recovery images, and a markedly increased signal intensity on diffusion-weighted imaging (DWI) with a reduced apparent diffusion coefficient (ADC) value (0.28610 23 mm 2 /s) (fig 1A-D). Her neurological symptoms and signs recovered almost completely 1 month later, after conservative management. A follow-up brain MRI, 3 months after discharge, showed nearly complete resolution of the corpus callosum lesion (fig 1E,F). DISCUSSIONCiguatera is a marine food poisoning caused by the ingestion of fish contaminated with ciguatoxin. 1 2 Diagnosis of ciguatera poisoning remains clinical, based on history and exclusion. The pathophysiology of ciguatera intoxication is as yet still unclear. The proposed mechanism reported in previous experimental studies was to bind to and open voltage-gated sensitive Na + channels at resting membrane potential, resulting in neural hyperexcitability. Followed by continuous Na + influx, cells become swollen because water enters the cell throughout the effect to maintain the osmotic equilibrium between intra-and extracellular space. 1 3 The mechanism was proven partially by the finding of the sural nerve oedema on biopsy. 4 Although midline corpus callosum changes on MRI are not specific, vascular lesions, traumatic axonal injury, demyelination lesions, neoplastic lesions, infection, metabolic abnormalities, epilepsy, antiepileptic drugs, thiamine deficiency and alcoholism were excluded by the clinical history, physical and neurological examination and laboratory studies in our case. 5 To our knowledge, reversible DWI and ADC abnormalities in the corpus callosum after ciguatera poisoning have never been reported before. Our patient developed reversible areas of significantly restricted proton diffusion in the corpus callosum without any evidence...

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“…Ciguatera is a marine food poisoning caused by the ingestion of fish contaminated with ciguatoxin 1 2. Diagnosis of ciguatera poisoning remains clinical, based on history and exclusion.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reversible corpus callosum lesion in ciguatera poisoning

et al. 2009

Journal of Neurology, Neurosurgery & Psychiatry

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“…Fishery products supply millions of tons of fish worldwide to feed low-income populations of costal and insular areas, and provide an alternative protein source in Europe and America. This demand exerts rising pressure on fishing grounds, and in combination with globalization of trade, is leading to increased import and greater consumption of fish sourced from areas where ciguatera is endemic (Achaibar et al, 2007;Garcia and Rosenberg, 2010). Thus, the disease is no longer restricted to the South and Equatorial Pacific, the Caribbean Sea and the Indian Ocean (Bagnis et al, 1979;Lange, 1994), where several hundreds of fish species are known to harbor the toxins responsible for ciguatera.…”

Section: A Global Public Health Issuementioning

confidence: 99%

Ciguatera fish poisoning: A first epidemic in Germany highlights an increasing risk for European countries

Mattei¹,

Vetter²,

Eisenblätter³

et al. 2014

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a b s t r a c tToxin-producing microalgae are thriving worldwide due to coral reef destruction and global warming with major consequences on ecosystems, international trade and human health. Microalgae belonging to the family of flagellate protists, in particular dinoflagellates, secrete a variety of high-molecular-weight polyether toxins that accumulate through the marine food chain to cause disease in humans by acting as sodium channel activator toxins; ciguatera is the most frequent seafood-borne illness worldwide with 50,000 to 500,000 global incidences per annum and is usually limited to endemic areas located between 35 northern and 35 southern latitude. The rising global incidence frequency renders it a major human health problem, because no curative treatment is available yet and reliable detection assays are lacking. During the last decade ciguatera has increasingly become endemic in previously unaffected areas for two reasons: first global warming has contributed to the emergence of dinoflagellate species in subtropical and even temperate regions that previously had been constrained to tropical areas and second: in Europe globalization of fishing industry and tourism has led to a progressive increase in the number of ciguatera cases and a lack of awareness among medical personnel contributes to under-reporting. We review, through a recent ciguatera outbreak in Germany, the risk for ciguatera poisoning in Europe and highlight characteristic symptoms, current knowledge about disease pathomechanisms and treatment options.

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“…Most of the cases are reported from countries within and surrounding the Pacific and Indian Oceans and the Caribbean. 4 Although most ciguatera cases are seen in endemic tropical areas, there is an increasing potential for cases to be encountered in temperate regions, as recently described. 5 In this study, we aim to describe two clusters of collective common-source CFP in Paris due to consumption of two fish imported from Guadeloupe (French West Indies).…”

Section: Two Clusters Of Ciguatera Fish Poisoning In Paris France Rmentioning

confidence: 93%

“…3 CFP is a significant public health issue in endemic areas that extend between 35 ∘ N and 35 ∘ S, approximately. 4 CFP is probably mostly undiagnosed even if its worldwide incidence is estimated to be around 50,000 cases annually. CFP is the most common poisoning linked to the consumption of finfish.…”

Section: Two Clusters Of Ciguatera Fish Poisoning In Paris France Rmentioning

confidence: 99%