Last reviewed: March 2018
Last updated: April  2018

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • oral numbness
  • dysphagia
  • dysarthria (common)
  • nausea (saxitoxin, tetrodotoxin)
  • vomiting (saxitoxin, tetrodotoxin)
  • diarrhoea (saxitoxin, tetrodotoxin)
  • weakness
  • ataxia/incoordination
  • hypertension (saxitoxin)
  • extreme pain (conotoxin)
  • hypotension or cardiovascular instability

Other diagnostic factors

  • light-headedness/dizziness
  • postural near-syncope/syncope
  • anxiety
  • loss of airway-protective reflexes
  • loss of adequate ventilation
  • hypoxia
  • bradycardia
  • apnoea
  • ventricular dysrhythmias

Risk factors

  • warmer waters
  • shellfish ingestion (saxitoxin)
  • xanthid crab ingestion (saxitoxin)
  • seafood ingestion (tetrodotoxin)
  • handling of blue-ringed octopus (tetrodotoxin)
  • handling of cone snail shells (conotoxin)
  • exposure to toxins in research/laboratory settings
  • bioterrorism

Diagnostic investigations

Investigations to consider

  • pulse oximetry
  • capnography
  • serial pulmonary function tests
  • arterial blood gases
  • chest x-ray
  • CT brain
  • serum electrolytes
  • high-performance liquid chromatography in flesh of seafood
Full details

Emerging tests

  • serum/urine toxin analysis
Full details

Treatment algorithm

ACUTE

Contributors

Authors VIEW ALL

Clinical Associate Professor

Division of Emergency Medicine

University of Washington School of Medicine

Seattle

WA

Disclosures

WTH is the author of a reference cited in this monograph.

Resident in Emergency Medicine

University of Washington School of Medicine

Seattle

WA

Disclosures

JAL declares that he has no competing interests.

Resident in Emergency Medicine

University of Washington School of Medicine

Seattle

WA

Disclosures

AA declares that he has no competing interests.

Peer reviewers VIEW ALL

Clinical Faculty

Rocky Mountain Poison and Drug Center

Denver

CO

Disclosures

SDP declares that he has no competing interests.

Professor of Pediatrics

University of Miami

Miller School of Medicine

Director

Florida Poison Center - Miami

Miami

FL

Disclosures

RSW declares that he has no competing interests.

Professor of Clinical Pharmacology and Toxicology

University of Sydney

Sydney

Australia

Disclosures

NB declares that he has no competing interests.

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