Paralytic Shellfish Poisoning by Saxitoxin: Two case reports

ABSTRACT

Paralytic shellfish poisoning results from consumption of mollusks that have fed on dinoflagellates capable of producing neurotoxins such as saxitoxin. The saxitoxin is concentrated in the shellfish and acts by decreasing sodium-channel permeability, thereby blocking neuronal transmission in skeletal muscles. Symptoms including paresthesia, perioral numbness, perioral tingling, nausea, vomiting, extremity numbness, extremity tingling, dizziness, ataxia, dysphagia, and weakness have been reported. In serious cases, respiratory hold may occur up to 6~24 hours after ingestion. Generally, the treatment for paralytic shellfish poisoning is supportive care, but mechanical ventilation is needed in serious cases acompanied by respiratory hold. We experienced two cases of paralytic shellfish poisoning. Respiratory hold was presented in one case and only mild paresthesia in the other case. After supportive management, including mechanical ventilation in former case, both patients were discharged without sequalae.