title: A mixed toxidrome presenting with bilateral ptosis with normal pupils: The first case in the literature.
abstract: Snakebite is an environmental hazard associated with a significant morbidity and mortality. Two main types of toxicity occur due to snakebite, namely vasculotoxicity and neurotoxicity. Neurotoxic snakebites present mainly with bilateral ptosis with dilated pupils and/or difficulty in breathing.Jatropha curcasbelongs to the familyEuphorbiaceaeand is commonly referred to as "Ratanjyot" in Gujarati. It has got many medicinal uses such as anticancerous properties and bio-oil. There are very few cases of its toxicity in adults. Toxicity from it causes meiosis, vomiting, diarrhea, etc., We will hereby discuss one such patient who consumedJ. curcasseeds intentionally, became drowsy and accidentally got bit by a snake, and then, the patient started having bilateral ptosis, but with normal-sized pupils. There is no case reported yet in the literature mentioning the combined toxicity of snakebite andJ. curcas, so we thought to publish this first case report of its kind in the world, thus discussing its diagnosis, symptoms, and treatment modalities.
authors.affiliation: Department of Medicine, BAPS Trust Hospital, Dabhoi, Vadodara, Gujarat, India.
authors.forename: Sanket
authors.initials: S
authors.lastname: Mahajan
authors.affiliation: Department of Medicine, BAPS Trust Hospital, Dabhoi, Vadodara, Gujarat, India.
authors.forename: Janki
authors.initials: J
authors.lastname: Shah
keywords: Jatropha curcas; normal pupils; ptosis; snake bite