title: Neuropsychological study of ciguatera fish poisoning: a longitudinal case-control study.
abstract: OBJECTIVE
  The purpose of the study was to evaluate the neuropsychological effects of ciguatera fish poisoning (CFP).
  
  
  METHODS
  In a longitudinal matched cohort study, 12 CFP cases and 12 matched friend-controls received baseline neuropsychological evaluations within one month after intoxication and follow-up evaluations approximately six months after baseline.
  
  
  RESULTS
  Only one case received intravenous mannitol treatment, which occurred 10 or more days after intoxication. At baseline and follow-up evaluations, there were no statistically significant differences between CFP cases and controls on cognitive measures. At baseline, however, CFP cases endorsed significantly greater subjective toxicity symptoms (e.g. fatigue, tingling sensations) and greater anxiety symptoms than controls. Follow-up evaluations suggested resolution of all symptoms after six months. Subsequent analyses, in which data from this study were pooled with data from an earlier pilot study, supported these results.
  
  
  CONCLUSIONS
  Untreated ciguatera was associated acutely with significant subjective neurotoxicity symptoms and anxiety which were transient, but not with objectively measured cognitive changes. Future investigation with a larger sample size is warranted.
authors.affiliation: Department of Neurology, University of Miami School of Medicine, Miami, FL, USA. melissafried@yahoo.com
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Friedman
authors.forename: Patricia
authors.initials: P
authors.lastname: Arena
authors.forename: Bonnie
authors.initials: B
authors.lastname: Levin
authors.forename: Lora
authors.initials: L
authors.lastname: Fleming
authors.forename: Mercedes
authors.initials: M
authors.lastname: Fernandez
authors.forename: Richard
authors.initials: R
authors.lastname: Weisman
authors.forename: Jeff
authors.initials: J
authors.lastname: Bernstein
authors.forename: Kathleen
authors.initials: K
authors.lastname: Schrank
authors.forename: Donna
authors.initials: D
authors.lastname: Blythe
authors.forename: Lorraine
authors.initials: L
authors.lastname: Backer
authors.forename: Andrew
authors.initials: A
authors.lastname: Reich
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000209:etiology; D016022:Case-Control Studies; D036841:Ciguatera Poisoning / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D020258:Neurotoxicity Syndromes / Q000209:etiology; D013997:Time Factors