title: Electromyographic and laboratory findings in acute Solanum torvum poisoning.
abstract: BACKGROUND
  Solanum torvum berries, known as susumber or turkey berries, are prepared as part of traditional Jamaican dishes usually served with cod and rice. Poisoning is rare. Although toxic compounds have never been definitively isolated, previous reports suggest toxicity results from inhibition of acetylcholinesterases. We present a case of susumber berry poisoning with detailed electromyographic studies and laboratory analysis.
  
  
  METHODS
  A 54-year-old woman presented to the Emergency Department (ED) complaining of vision, speech, and gait changes; emesis; and diffuse myalgias following consumption of susumber berries. The physical examination demonstrated an intact, lucid mental status, miosis, opsoclonus, severe dysarthria, dysmetria, mild extremity tenderness and weakness, and inability to ambulate. Her symptom constellation was interpreted as a stroke.
  
  
  CONCLUSIONS
  Electromyography demonstrated a pattern of early full recruitment as well as myotonia during the period of acute toxicity. Additionally, solanaceous compounds, in particular solasonine and solanidine, were identified in leftover berries and the patient's serum. Store-bought commercial berries and subsequent serum samples were free of such toxic compounds. EMG studies, together with a laboratory analysis of berries or serum can assist in the differential diagnosis of stroke, and provide both a prognostic screening and confirmation of suspected glycoside toxicity.
authors.affiliation: a Saul R Korey Department of Neurology , Montefiore Medical Center, Albert Einstein College of Medicine , Bronx , NY , USA ;
authors.forename: Robert L
authors.initials: RL
authors.lastname: Glover
authors.affiliation: b Division of Emergency Medicine, Department of Medicine , Medical University of South Carolina , Charleston , SC , USA ;
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Connors
authors.affiliation: c Centre for Addiction and Mental Health , Toronto , ON , Canada ;
authors.forename: Cristiana
authors.initials: C
authors.lastname: Stefan
authors.affiliation: c Centre for Addiction and Mental Health , Toronto , ON , Canada ;
authors.forename: Ernest
authors.initials: E
authors.lastname: Wong
authors.affiliation: d Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine , New York University School of Medicine , New York , NY , USA ;
authors.forename: Robert S
authors.initials: RS
authors.lastname: Hoffman
authors.affiliation: d Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine , New York University School of Medicine , New York , NY , USA ;|e New York City Poison Control Center , New York , NY , USA.
authors.forename: Lewis S
authors.initials: LS
authors.lastname: Nelson
authors.affiliation: a Saul R Korey Department of Neurology , Montefiore Medical Center, Albert Einstein College of Medicine , Bronx , NY , USA ;
authors.forename: Mark
authors.initials: M
authors.lastname: Milstein
authors.affiliation: d Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine , New York University School of Medicine , New York , NY , USA ;|e New York City Poison Control Center , New York , NY , USA.
authors.forename: Silas W
authors.initials: SW
authors.lastname: Smith
authors.affiliation: a Saul R Korey Department of Neurology , Montefiore Medical Center, Albert Einstein College of Medicine , Bronx , NY , USA ;
authors.forename: Michael
authors.initials: M
authors.lastname: Swerdlow
mesh_terms: D004144:Diosgenin / Q000097:blood / Q000506:poisoning; D004576:Electromyography; D005260:Female; D005517:Foodborne Diseases / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D005638:Fruit; D006801:Humans; D008875:Middle Aged; D020258:Neurotoxicity Syndromes / Q000097:blood / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D012991:Solanaceous Alkaloids / Q000097:blood / Q000506:poisoning*; D032322:Solanum / Q000506:poisoning*
chemical_list: D012991:Solanaceous Alkaloids; C026608:alpha-solamargine; D004144:Diosgenin; C013255:solanidine
keywords: Electromyography; solanum torvum; susumber berries