A clinical and neurophysiological study of scorpion envenomation in Assiut, Upper Egypt

Abstract

Scorpion envenomation (SE) represents an agonizing problem in many countries, especially in rural areas. This clinical and neurophysiological study aimed to determine the relative frequency of scorpion envenomation in the Assiut area, in Upper Egypt. Full clinical evaluation was carried out for all children < or =18 y of age included in the study. Electroencephalography (EEG), electromyography (EMG) and motor conduction velocity measurements were carried out for a variable number of children. SE was recorded in 302 cases per year in this area. Of these, 78.5% were < or =18 y of age. SE occurred most commonly during the summer months. Clinical evaluation revealed that SE results in marked autonomic manifestations, principally sinus tachycardia (78.1%), vomiting (70.5%) and hyperthermia (53.2%). It also results in many neuropsychiatric manifestations, such as agitation and restlessness (17.7%) and disturbance of consciousness (8.0%). Electroencephalographic study of 184 cases of SE in paediatric patients aged < or =18 y revealed abnormalities in 77.7%. Study of mean distal latency and motor conduction velocity revealed that patients had a significantly shorter distal latency and a more rapid motor conduction velocity compared with the control group. This was true for both the inflicted limb and the contralateral limb. Most of the complications of SE are due to irritability of the central and peripheral nervous systems.

Epidemiological Characteristics of Scorpionism in West Azerbaijan Province, Northwest of Iran

“…In this study, similar to some other studies, hand, leg, trunk, head and neck, respectively, are more likely to be stung by scorhttp://jad.tums.ac.ir Published Online: June 30, 2020 pions (18,29,(33)(34)(35)(36). Like our results in some studies foot and hand have been more frequent bitten by scorpions (16,20,(22)(23)(24)(25).…”

Scorpion Sting Envenomation in Children in Southeast Turkey

“…Several authors have found similar results in terms of higher numbers of stings in boys than in girls. 14,15 Boys probably go outside more commonly and often play in places where scorpions live, such as rubbish areas in our country.…”

Scorpion sting nephropathy

“…Pain and sweating with faintness constitute Stage I of envenomation [ 6 ]. Local pain and parasthesias apart, signs and symptoms of envenomation arising from exaggerated autonomic activity (parasympathetic and sympathetic) include cool extremities, vomiting, diarrhoea, hyperthermia, abdominal colic, priapism, hypotension or hypertension, sinus tachycardia, congestive heart failure, myocarditis, dysrhythmias, heart blocks and pulmonary oedema [ 31 ]. These features occur within 30 min to 4 h and can last for up to 72 h (especially tachycardia) [ 32 ].…”

“…Sequential progress through all stages may not occur in children. The nervous system manifestations are infrequent and they include encephalopathy, seizures, restlessness, areflexia, psychosis, strokes and muscle cramps [ 31 ]. The first two neurological complications are invariably fatal in children [ 32 ].…”