title: Viper bite causing an isolated lower motor neuron-type of facial palsy.
abstract: We describe an unusual case of viper (Daboia russelii) bite in a 48-year-old man from the state of Karnataka in southern India. He presented in a hypotensive state with a left lower motor neuron-type of facial palsy, necrosis at the site of the bite and acute renal failure. His laboratory parameters revealed renal failure and deranged coagulation parameters. He was treated with intravenous antibiotics and polyvalent antiserum venom, and dialysed in view of the renal failure. His renal function and coagulation abnormalities improved, and the facial palsy recovered with the treatment. The snake bite located away from the face, the facial palsy occurring a few hours after the venom injection and the rapid recovery following antivenin administration, support that the palsy was a direct result of systemic envenomation. To the best of our knowledge, an isolated lower motor neuron-type of facial palsy as a manifestation of systemic toxicity of a viper bite, has not been previously reported.
authors.affiliation: Department of Nephrology, Kasturba Medical College, Manipal, Karnataka 576104, India. drwaqaswahid@gmail.com
authors.forename: W W
authors.initials: WW
authors.lastname: Baig
authors.forename: A R
authors.initials: AR
authors.lastname: Prabhu
authors.forename: C
authors.initials: C
authors.lastname: Kumar
mesh_terms: D000818:Animals; D000997:Antivenins / Q000627:therapeutic use*; D005158:Facial Paralysis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000473:pathology; D051437:Renal Insufficiency / Q000209:etiology / Q000628:therapy; D017840:Daboia; D012909:Snake Bites / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology*; D014757:Viper Venoms / Q000378:metabolism
chemical_list: D000997:Antivenins; D014757:Viper Venoms