title: Comparative study of electrophysiological changes in snake bites.
abstract: OBJECTIVE
  To study and compare the electrophysiological changes in neuroparalytic or vasculotoxic snakebites.
  
  
  METHODS
  40 patients who had a definite history of snakebite, either vasculotoxic or neuroparalytic, were selected. They were grouped as Group A, 20 patients having a neuroparalytic snakebite with definite envenomation at the time of admission, and Group B, 20 patients having a vasculotoxic snakebite with definite envenomation at the time of admission. All patients underwent a detailed clinical examination, all relevant investigations and nerve conduction studies according to protocol.
  
  
  RESULTS
  In this study, we noticed that the motor nerve conduction amplitude, conduction velocity and distal latency were within normal limits in both the groups. On RNS (repetitive nerve stimulation study) of facial and median nerves, a decremental response was seen in 13 (65%) patients in facial nerve and in 7 (35%) patients in median nerve in Group A; while, the same response was seen in 8 (40%) patients in facial nerve and 3 (15%) patients in median nerve in Group B. A post exercise decremental response was seen in 13 (65%) patients in median nerve and 16 (80%) patients in facial nerve in Group A; and, in 3 (15%) patients in median nerve and 8 (40%) patients in facial nerve in Group B.
  
  
  CONCLUSIONS
  In our study, we noticed that the decremental response on RNS was not only present in neuroparalytic snake bite (post-synaptic neuromuscular blockade) but also in vasculotoxic snakebite [pre-synaptic neuromuscular blockade] (seen in Russel's viper).
authors.affiliation: Department of Medicine, BJ Medical College and Sassoon General Hospital, Pune, Maharashtra, India.
authors.forename: Patwari
authors.initials: P
authors.lastname: Panduranga
authors.forename: S A
authors.initials: SA
authors.lastname: Sangle
authors.forename: Abhay A
authors.initials: AA
authors.lastname: Mane
authors.forename: Suyog
authors.initials: S
authors.lastname: Doshi
authors.forename: D B
authors.initials: DB
authors.lastname: Kadam