Neurologic Signs of Ciguatera Disease: Evidence of their Persistence

Abstract

Ciguatoxins exert their effect on the voltage-sensitive sodium channels of the cellular membranes of all excitable tissues. This effect confers to ciguatera disease (CD) its neurologic hallmarks. A prospective study among French Polynesian adults over a two-month period was conducted to characterize and determine the persistence of neurologic symptoms of CD. We compared 47 patients with CD with 125 controls. In the acute phase of the disease, patients had mainly sensory disturbances as detected by an hypoesthesia on the palm of the hand and poorer sway performance compared with controls. Follow-up two months showed improvement of sway performance that eventually reaching control levels. However, for light-touch threshold, even if we observed a decrease threshold towards normal values, more than 50% of patients did not reach normal values 60 days after disease onset. Our results support the existence of neurologic impairments of CD and suggest their persistence for at least two months after onset.

Adult Women’s Blood Mercury Concentrations Vary Regionally in the United States: Association with Patterns of Fish Consumption (NHANES 1999–2004)

“…An overall pattern of higher BHg levels has also been reported among people living on U.S. islands [Hawaii (Sato et al 2006)] and territories [e.g., Puerto Rico (Ortiz-Roque and López-Rivera 2004)]. A similar pattern has been repeated in other islands [Bermuda (Dewailly and Pereg 2004; see also Bermuda Biological Stations for Research 2004), Fiji (Kumar et al 2006), Seychelles (Myers et al 2007), and Tahiti (Chateau-Degat 2005; Dewailly et al 2008)] compared with inland populations. Among these island populations, BHg concentrations at the upper end of the distribution fall into the range of 50 μg/L (~ 250 nmol/L) and higher (Chateau-Degat 2005).…”

An Updated Review of Ciguatera Fish Poisoning: Clinical, Epidemiological, Environmental, and Public Health Management

“…After the initial or acute illness, many symptoms may persist a few days to several weeks or months [44,72,78,100], including, peripheral neurologic symptoms (e.g., paresthesias in the extremities and pruritus), and systemic symptoms (e.g., malaise, weakness, generalized fatigue, and headaches).…”

“…Neuropsychological symptoms (e.g., depression, anxiety, inability to concentrate, subjective memory loss) [7,64,65,68,78,86,101,102,103,104] have also been reported, after the initial or acute illness. One longitudinal study assessed symptoms in 12 CFP patients and 12 healthy control subjects, at a baseline evaluation (within a few weeks after intoxication) and at a six-month follow-up evaluation.…”

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)

“…Cardiovascular disturbances (hypotension, bradycardia), are less prevalent, and are suggestive of the severity of the poisoning [ 24 , 25 ]. Other initial symptoms may include a general malaise, pain and weakness of the lower limbs, intense pruritus without cutaneous signs, arthralgia and paresthesia (typically perioral and in the extremities), in the absence of fever [ 25 , 26 ]. 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 ].…”