Title: Viper Bite Envenomation- A Clinical study searching for Neurological Manifestations
Authors: Ajith S.N, Jacob Antony, Sajan Christopher
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.111
Abstract
Background: Viper bite envenomation is prevalent in northern Kerala. Its clinical manifestation is varied. Haematological features dominate its clinical presentation. This study focuses on its neurological effects.
Methods: We conducted a prospective study involving 52 patients in Kozhikode district with viper bite envenomation of which 35 were bitten by Russell’s viper and the rest 17 by saw-scaled viper. All cases were subjected to detailed clinical evaluation with emphesis to local effects, hemorrhagic and local manifestations. Relevant investigations were done with special tests like neostigmin test in selected cases
Results: All patients had signs of local envenomation with local serosanginous blister formation in 8% and regional lymphadenopathy in 24%. Paralytic symptoms developed only in patients with Russell’s viper envenomation. These were ptosis in 28%, external ophthalmoplegia in 20%, dysarthria (8%) and dysphagia (2.8%)
Conclusions: Neurological manifestations do occur after viper bite envenomation. It is observed only after Russell’s viper bite. Ptosis and external ophthalmoplegia are the commonly seen manifestations, dysarthria and dysphagia occur in moderate to severe envenomation.
Keywords: Viper, Envenomation, neurological manifestations.
