Ciguatera poisoning.
Ciguatera is a form of poisoning that occurs after eating tropical and subtropical ciguatoxic fish. The ciguatoxins are a family of heat stable, lipid soluble cyclic polyether compounds that bind to and open voltage-sensitive Na(+) channels at resting membrane potential, resulting in neural hyperexcitability, as well as swelling of the nodes of Ranvier. The authors describe a 45-year-old man who developed acute gastrointestinal symptoms in Antigua soon after eating red snapper and grouper, potentially "ciguatoxic fish". This was followed by neurological symptoms 24-48 hours later, including temperature reversal (paradoxical dysaesthesia), intense pruritus and increased nociception as a result of a small fibre peripheral neuropathy. The patient's symptoms and small fibre neuropathy improved over a period of 10 months.
Achaibar
Kira C
KC
Department of Clinical Neurosciences, Imperial College London, UK.
Moore
Simon
S
Bain
Peter G
PG
D000818:Animals; D036841:Ciguatera Poisoning / Q000453:epidemiology / Q000266:history / Q000503:physiopathology; D005399:Fishes; D049671:History, 18th Century; D049691:History, Medieval; D006801:Humans; D008297:Male; D008875:Middle Aged; D010151:Paintings