Seastrokes: A New Threat for North Carolina Swimmers?

Abstract

Spinal cord infarcts have been reported in young healthy patients following contact with the water on the beaches of North Carolina. Although their exact cause is not known, contact with a toxic marine animal has been proposed. We describe a patient who suffered a “seastroke” and review the pertinent literature.

Raising Awareness on the Clinical and Forensic Aspects of Jellyfish Stings: A Worldwide Increasing Threat

“…Other systemic reactions Acute renal failure Hydrozoa [120] Arrythmia Hydrozoa [121] Rhabdomyolysis Hydrozoa [122,123] Erythema nodosum Hydrozoa [124] Deep venous thrombosis Scyphozoa [125] Facial swelling unknown [126,127] Digital necrosis unknown [128][129][130] Spinal cord infarct unknown [131] Cellulitis Scyphozoa [79] Myalgia Scyphozoa, Cubozoa [132] Abdominal cramping Scyphozoa, Cubozoa [13,119] Cough Scyphozoa [13,119] Nausea and vomiting Hydrozoa [133] Cold sweating Hydrozoa [133] Delayed eye swelling unknown [134] Long term reactions Keloids Cubozoa [71,73] Lichen planus unknown [135] Hyperpigmentation Scyphozoa, Hydrozoa, Cubozoa [78,86,136] Fat atrophy unknown [137] Delayed necrosis Cubozoa [82] Gangrene Cubozoa [138] Persistent hypersensitivity Scyphozoa [139] Koebner Phenomenon unknown [140] Persistent neuropathy unknown [111] Granulomatous infiltration Cubozoa [87] Nodular papular eruption Cubozoa [84] Potentially fatal reactions Immediate cardiac arrest Cubozoa [141][142][143] Acute myocardial infarction unknown [29,31] Rapid respiratory arrest Cubozoa, Scyphozoa…”

Toxic and Metabolic Myelopathies

“…Jellyfish toxins have been proposed as a cause but the mechanism of neural tissue damage is unknown. It is also unclear why in all of the reported cases the abnormalities involved only the spinal cord and brainstem but spared the brain 65 Some jellyfish toxins affect the calcium channels of neurons, a process that could lead to cytotoxic edema, failure of cellular energetics, and eventually to irreversible damage such as seen in ischemia. Some authors have postulated that damage to the spinal cord is not direct but due to systemic hypotension with subsequent infarctions.…”

“…Some authors have postulated that damage to the spinal cord is not direct but due to systemic hypotension with subsequent infarctions. 65 …”

“…Neurologic signs and symptoms depend on the level of spinal cord involvement and include severe back pain, loss of sphincter control, paraplegia or paraparesis, or quadriplegic or tetraplegia in patients with higher cord lesions. 65 …”