Intractable Seizures and Rehabilitation in Ciguatera Poisoning

Abstract

Ciguatera fish poisoning is the most frequently reported seafood toxin illness associated with the ingestion of contaminated tropical fish. Diagnosis relies on a history of recent tropical fish ingestion and subsequent development of gastrointestinal, cardiovascular, and neurological symptoms. Ciguatera poisoning usually has a self-limited time course, and its management involves symptomatic control and supportive care. This case report presents an uncommon case of ciguatera poisoning with prolonged intractable seizures refractory to standard antiseizure medications. The patient also had significant functional decline that responded to rigorous inpatient rehabilitation not previously described in literature.

Tectus niloticus (Tegulidae, Gastropod) as a Novel Vector of Ciguatera Poisoning: Clinical Characterization and Follow-Up of a Mass Poisoning Event in Nuku Hiva Island (French Polynesia)

“…Among neurologic symptoms, cold allodynia (dysesthesia in response to cold stimulations), commonly reported as “temperature reversal”, is a specificity considered nearly pathognomonic of CFP [ 27 , 28 , 29 ]. Although fatal cases of CFP remain anecdotal (<0.1%) [ 30 ], this disease may prove extremely debilitating and deeply distressing in the short- or long-term (months or years) [ 31 , 32 , 33 ].…”

Ciguatera fish poisoning in Brazilian traveler to Caribbean

“…Table 1 describes the case reports of patients with ciguatera poisoning acquired in the Caribbean. 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 The incidence among Brazilians returning from high-risk regions is unclear because it is not a mandatory reportable illness. There has been a previous report of ciguatera poisoning in Brazilians travelers.…”