Mild ciguatera poisoning: Case reports with neurophysiological evaluations.
ABSTRACT Ciguatera poisoning causes mainly gastrointestinal and neurological effects of variable severity. However, symptoms of peripheral neuropathy with paresthesias and paradoxical disturbance of thermal sensation are the hallmark. Electrophysiological studies are often normal, except in severe cases. We report four people who developed mild ciguatera poisoning after barracuda ingestion. Electrophysiological studies documented normocalcemic latent tetany. These findings are consistent with ciguatoxin's mechanism of toxicity, which involves inactivation of voltage-gated Na(+) channels and eventually increases nerve membrane excitability.
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ABSTRACT: Ciguatera fish poisoning (CFP) is acquired through consumption of tropical reef fishes, contaminated with potent neurotoxins, ciguatoxins (CTXs), produced by benthic dinoflagellate of the Gambierdiscus genus. Both spatially and temporally unpredictable, a tainted fish is impossible to differentiate from an untainted one by appearance, taste, texture or odour. Given the predominance of reef fish in the diet of insular countries, the risk of CFP is ever-present. In the Pacific where the incidence of CFP is the highest, the consequences on public health and socio-economy can be extremely severe. Multidisciplinary in nature, the present review revisits the phenomenon of CFP, covering certain of its aspects, notably the etiology, toxicology, ecotoxicology, pharmacology, pathology and the treatments administrated. These aspects of CFP have been reviewed in relation to other poisoning syndromes: tetrodotoxin poisoning and other dinoflagellates- or diatoms-associated intoxications such as paralytic (PSP), diarrhetic (DSP), neurotoxic (NSP), amnesic (ASP) and azaspiracid shellfish poisoning (AZP) and palytoxin poisoning. Based on case reports and bibliographic accounts, a list inventorying the western medicines prescribed to patients suffering from CFP has been established. Within the last two decades, several of the herbal remedies have been evaluated for their efficiencies in in vivo and in a number of in vitro tests, which have also been reviewed herein.02/2011; 28(1):1-26. DOI:10.1071/SP10001
Article: La ciguatéra[Show abstract] [Hide abstract]
ABSTRACT: Ciguatera, an ichtyosarcotoxism linked to the consumption of usually healthy coral fish is a common poisoning in the Pacific, Caribbean and Indian Ocean where it is endemic. However, increased tourism and commercial transportation of tropical fish for consumption make it an unexceptional intoxication in countries away from its endemic area. Environmental stresses such as climate changes also contribute to the expansion of its geographical area. The non-specific clinical symptomatology is characterized by the occurrence of gastrointestinal, cardiovascular, nervous and general signs few hours after eating a ciguatoxic fish. The diagnosis is clinical and relatively easy in endemic areas but much less for physicians who are rarely confronted with, which is a source of prolonged diagnostic delays and a significant increase in spending. Treatment of ciguatera is symptomatic but new treatments, still experimental, give a real hope for the future.La Presse Médicale 09/2014; DOI:10.1016/j.lpm.2014.01.019 · 1.17 Impact Factor
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ABSTRACT: Among the various hazards occurring in fish and seafood chemical hazards and in particular toxins (ciguatera, scombroid fish poisoning, paralytic shellfish poisoning, neurotoxic (brevetoxic) shellfish poisoning, puffer fish poisoning, diarrhetic shellfish poisoning) have an important place in food poisoning cases. On the other hand, some of the chemical hazards are often due to the pollution of the environment (heavy metals, dioxins, polychlorinated biphenyls, and halogenated aromatic hydrocarbons) and their detection is neither rapid nor facile. As a result there was a great need for developing new rapid and effective methods toward the chemical hazards determination mainly because of their high toxicity. The aim of this review is to provide the information about the new up-to-date detection techniques (Immunological, Chemical and Biochemical, and Molecular assays) in conjunction with detection limits. The latter is made possible by means of inclusion of seven comprehensive and, in most case cases, very extended tables. A reference is also made on the risk characterization of toxins as regards their importance to food contamination or poisoning.Critical reviews in food science and nutrition 11/2014; 54(11):1473-528. DOI:10.1080/10408398.2011.641132 · 3.73 Impact Factor