RESUMO
Ciguatera toxicity is a poisoning from consuming reef fish that had fed on dinoflagellates such as Gambierdiscus toxicus found along coral reefs. The toxin is oil soluble, odorless, colorless, tasteless, heat stable, and is concentrated in larger carnivorous fish such as amberjack, barracuda, eel, grouper, red snapper, sea bass, and Spanish mackerel. Onset of symptoms is usually within 6-12 hours after ingestion. Gastrointestinal symptoms lasting 1-2 days include abdominal pain, nausea, vomiting, and diarrhea. Neurological symptoms may persist for weeks or several months or--rarely--years and include circumoral and extremity paresthesias, temperature sensation reversal, itching, weakness, ataxia, and others. A patient with burning hands and feet who had not found relief using other methods had diagnosis of ciguatera toxicity assisted by hypnotically refreshed memory followed by rapid relief with hypnotic suggestions in 1 session and remained free of symptoms.
Assuntos
Ciguatera/terapia , Hipnose/métodos , Manejo da Dor/métodos , Dor/psicologia , Idoso , Treinamento Autógeno , Ciguatera/diagnóstico , Ciguatera/psicologia , Pé/inervação , Mãos/inervação , Humanos , Masculino , Dor/etiologia , Regressão Psicológica , SugestãoRESUMO
PURPOSE: The purpose of the study was to evaluate the neuropsychological effects of ciguatera fish poisoning (CFP). METHOD: In a longitudinal matched cohort study, 12 CFP cases and 12 matched friend-controls received baseline neuropsychological evaluations within one month after intoxication and follow-up evaluations approximately six months after baseline. RESULTS: Only one case received intravenous mannitol treatment, which occurred 10 or more days after intoxication. At baseline and follow-up evaluations, there were no statistically significant differences between CFP cases and controls on cognitive measures. At baseline, however, CFP cases endorsed significantly greater subjective toxicity symptoms (e.g. fatigue, tingling sensations) and greater anxiety symptoms than controls. Follow-up evaluations suggested resolution of all symptoms after six months. Subsequent analyses, in which data from this study were pooled with data from an earlier pilot study, supported these results. CONCLUSION: Untreated ciguatera was associated acutely with significant subjective neurotoxicity symptoms and anxiety which were transient, but not with objectively measured cognitive changes. Future investigation with a larger sample size is warranted.