Early Morning Neuroparalytic Syndrome
Abstract
Snake bite is a common problem seen in the rural parts of India and is associated with a high rate of mortality due to their related toxicity. Neurotoxicity from the elapid bite may manifest as the early morning neuroparalytic syndrome (EMNS) or even as Locked in syndrome. Determining the types of toxicity in the patient is based on cl inical signs and laboratory findings or by direct examination of the snake. Patients presenting as EMNS do not have bite marks on their body and hence the diagnosis may be complicated. A 14 year old girl presented with a tingling sensation over her body who later developed respiratory failure is reported here. She was treated with a standard regimen of anti-snake venom (ASV) and atropine – neostigmine along with other supportive measures. She made a remarkable recovery with the above treatment and hence it is essential to consider a possibility of elapid envonomation in these patients presenting with acute neuroparalysis in snake bite endemic areas.
When publishing with Kerala Medicial Journal (KMJ), authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. Work includes the material submitted for publication and any other related material submitted to KMJ. In the event that KMJ does not publish said work, the author(s) will be so notified and all rights assigned hereunder will revert to the author(s).
The assignment of rights to KMJ includes but is not expressly limited to rights to edit, publish, reproduce, distribute copies, include in indexes or search databases in print, electronic, or other media, whether or not in use at the time of execution of this agreement.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
The author(s) hereby represents and warrants that they are sole author(s) of the work, that all authors have participated in and agree with the content and conclusions of the work, that the work is original, and does not infringe upon any copyright, propriety, or personal right of any third party, and that no part of it nor any work based on substantially similar data has been submitted to another publication.