J Korean Soc Emerg Med.  1998 Sep;9(3):465-470.

A Case of Recovery from Suspended Animation caused by Puffer fish Poisoning: a case report

Abstract

Tetrodotoxin is a neurotoxin produced by about 90 species of puffer fish and causes paralysis of central nervous system and peripheral nerves by blocking the movement of all monovalent cations. Ingestion of tetrodotoxin produces clinical manifestations such as paresthesias(within 10-45 min), vomiting, lightheadedness, salivation, muscle twitching, dysphagia, difficulty in speaking, convulsion and death that expressed by cardiopulmonary arrest with loss of brain stem reflex sometimes. Tetrodotoxin prevents or delays ischemia induced neuronal death by way of following 3 mechanisms. Firstly, it reduces the energy demand of the brain tissues. Secondly, it delays or even prevents anoxic depolarization. Finally, it diminishes ischemia induced cell swelling and cerebral edema. We report a case of puffer fish poisoning which presented with cardiopulmonary arrest and loss of brain stem reflex, but completely recovered by aggressive cardiopulmonary resuscitation.


MeSH Terms

Brain
Brain Edema
Brain Stem
Cardiopulmonary Resuscitation
Cations, Monovalent
Central Nervous System
Deglutition Disorders
Dizziness
Eating
Heart Arrest
Ischemia
Neurons
Paralysis
Peripheral Nerves
Poisoning*
Reflex
Salivation
Seizures
Tetraodontiformes*
Tetrodotoxin
Vomiting
Cations, Monovalent
Tetrodotoxin
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