Binocular Diplopia After A Snakebite

Year 2021, , 79 - 81, 18.08.2021

Fatih Çalışkan , Celal Katı , Hızır Ufuk Akdemir , Yıldıray Çelenk

https://doi.org/10.33706/jemcr.882234

Abstract

A snakebite is an injury caused by a bite from a snake, often resulting in puncture wounds inflicted by animal’s fangs and sometimes resulting in envenomation. Venom may cause a complex condition that can be local damage, neuromuscular dysfunction, or systemic vascular damage leading to hemolysis. The main cause of mortality and morbidity in snake bites is neurotoxicity, and the main cause of neurotoxicity is sudden neuromuscular paralysis. Synthesis, packaging, transport, and release of the neurotransmitter acetylcholine in the presynaptic field, blockade of postsynaptic nicotinic acetylcholine receptors, acetylcholine esterase inhibition, muscarinic effects of some snake toxins, and inhibition of voltage-gated calcium gates, changes in the neuromuscular junction after snakebite can explain neuromuscular paralysis secondary to the snake bite. We present a case, with bilateral diplopia and ptosis after snakebite, that was recovered after the use of anticholinesterase therapy and antivenom.

Keywords

diplopia, snake bites, antivenins, cholinesterase inhibitors

Thanks

All authors thank the immortal friend and colleague, Prof. Dr. Kemal Balcı (1971-2019), for his support in the patient management and the academic field.

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