A Case of Strychnine Poisoning from a Southeast Asian Herbal Remedy.

BACKGROUND: Strychnine is a highly toxic alkaloid found in both naturally occurring compounds and commercial products. Extracts of fruits from the strychnine plant have been used in Southeast Asia as remedies for various illnesses. We describe strychnine poisoning from ingestion of a Southeast Asian herbal supplement quantitatively confirmed by serum and urine analysis. CASE REPORT: A 40-year-old Cambodian woman presented to the emergency department with a complaint of jaw pain and spasms. The patient was staying with a relative and drank 2 oz from an unmarked bottle that she thought contained vodka. She then developed trismus and abdominal cramping, after which a family member said the bottle contained a compound called "slang nut." Her vital signs were as follows: heart rate 102 beats/min, blood pressure 142/72 mm Hg, respiratory rate 20 breaths/min, and oxygen level 100%. The physical examination revealed no significant abnormalities. Serum toxicologic screens were negative except for strychnine levels that revealed a serum concentration of 350 ng/mL and a urine concentration >200 ng/mL. The patient was observed for 2.5 h and discharged with no long-term complications. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Strychnine is a well-known compound that has been used in poisons, rodenticides, and performance enhancing drugs for years. In the Western world, strychnine is a much less common poisoning given that its use has been restricted because of the potential for severe toxicity; however, given its potentially high mortality, it is important to be aware of other sources of exposure, including those from herbal and homeopathic remedies.

Four types of traditional Chinese medicine inducing epileptic seizures.

Traditional Chinese medicine has been used to treat disease in China for more than five thousand years. Over the last few decades it has been used increasingly in other countries as well. As its use has spread, interest in the adverse effects of traditional Chinese medicine, including epilepsy and epileptic seizures, has grown. To date, four types of traditional Chinese medicine have been found to induce epileptic seizures. In this review we will summarize the current knowledge about possible epileptogenic mechanisms of nux vomica, illicium henryi, betelnut and mulberry drawing on botanical, phytochemical, toxicological and animal studies.

Ayurvedic processed seeds of nux-vomica: neuropharmacological and chemical evaluation.

The effect of detoxification on Strychnos nux-vomica seeds by traditional processing with aloe and ginger juices (B), by frying in cow ghee (C), and by boiling in cow milk (D) was investigated. The ethanolic extracts of these samples were subjected to spontaneous motor activity (SMA), pentobarbitone-induced hypnosis, PTZ induced convulsions, diazepam-assisted protection, and morphine-induced catalepsy. All samples reduced SMA and inhibited catalepsy. The seeds processed in milk (D) showed the lowest strychnine content in the cotyledons, exhibited marked inhibition of PTZ induced convulsions and maximal potentiation of hypnosis, and were the safest (LD(50)).

[Changes in anxiety level of Wistar rats under the influence of maximally-diluted solution of a plant alkaloid]. / Izmenenie urovnia trevozhnosti u krys linii Vistar pod vliianiem sverkhslabogo rastvora rastitel'nogo alkaloida.

A very dilute solution of Nux Vomica 200 plant alkaloid was applied onto the tongue of Wistar rats. The level of rats' anxiety was estimated by their behavior in elevated plus-maze. The dry application led to substantial changes in rats' behavior. In "passive" rats previously defined by the forced swimming tests changes in behavior were most prominent. The possible influence of the drug under study on the adaptive abilities of this group of animals is discussed.