Reversible cerebellar dysfunction associated with ciguatera fish poisoning.
BACKGROUND
Ciguatera-fish poisoning (or ciguatera) is a common but underdiagnosed food-borne illness related to fish consumption that is characterized by nausea, vomiting and neurologic symptoms such as tingling in the fingers or toes.


OBJECTIVE
We describe the case of a young man who suffered from diarrhea and abdominal pain after eating raw fish and who also developed severe ataxia with spontaneous downbeat and perverted head-shaking nystagmus.


METHODS
The patient experienced visual fixation suppression failure during the bithermal caloric test and bilateral smooth-pursuit impairment. Oculomotor findings suggested dysfunction of the vestibulocerebellum, especially the flocculus.


CONCLUSIONS
These findings suggest that both the peripheral and the central nervous systems can be involved in ciguatera.
Department of Neurology, Chonbuk National University Medical School, Jeonju, South Korea.
Sun-Young
SY
Oh
Do-Hyung
DH
Kim
Man-Wook
MW
Seo
Byoung-Soo
BS
Shin
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D002524:Cerebellar Ataxia / Q000209:etiology*; D036841:Ciguatera Poisoning / Q000150:complications* / Q000188:drug therapy; D003967:Diarrhea / Q000209:etiology; D004234:Diuretics, Osmotic / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008353:Mannitol / Q000627:therapeutic use; D009759:Nystagmus, Pathologic / Q000209:etiology*
D004234:Diuretics, Osmotic; D008353:Mannitol