Neurological and Systemic Manifestations of Severe Scorpion Envenomation

Abstract

Scorpion envenomation is a life-threatening toxicological emergency and considered as a major public health problem, especially in endemic regions (India, Africa, Latin America); it is generally characterized by low resources and tropical or subtropical weather. Scorpion envenomation is especially fatal in the first hours, usually due to respiratory and/or cardiovascular collapse. The neurologic manifestations, triggered by multiple neurotoxic mechanisms, are varied and complex and mostly reported in children. The aim of this review is to clarify the epidemiologic characteristics and clinical manifestations as well as diagnosis and management of neurologic complications following scorpion envenomation. The management of patients with severe clinical forms is based on early recognition of the sting, antivenom serum administration, and cardiorespiratory and systemic support.

Tendência temporal e perfil epidemiológico dos acidentes por animais peçonhentos no Brasil, 2007-2019

“… 12 Although scorpion stings are frequent and generally only result in local clinical presentations, this is not the case regarding systemic manifestations, for which 5% of reported cases are severe and of these, 0.3% are fatal. 15 The Northern region had a higher presented case fatality ratio for scorpion stings (0.17%), in relation to the other regions of the country. The fatal cases were found in the Amazon region, mainly following Tityus metuendus and Tityus obscurus stings.…”

“…12 Embora as picadas de escorpiões sejam frequentes e ocasionem apenas apresentações clínicas Epidemiologia e Serviços de Saúde, Brasília, 31(3):e2022025, 2022 locais, na maioria das vezes, o mesmo não é verificado nas manifestações sistêmicas, para as quais 5% dos casos notificados são graves, e destes, 0,3% fatais. 15 A região Norte apresentou maior letalidade por escorpionismo (0,17%), em relação às demais regiões do país. Os casos letais foram observados na região amazônica, principalmente após picadas de Tityus metuendus e Tityus obscurus.…”

Scorpion sting and blindness: A case report

“…[ 5 ] We could not find any case in the literature where a scorpion sting has caused blindness secondary to an occipital infarct. [ 5 ] Atypical presentation, such as occipital infarct causing blindness in a patient with scorpion sting is probably due to the vasculotoxic effect of the venom, prompted us to write this case report.…”

“…The key message from this case report is[ 5 ] that scorpion stings though very common rarely can present as stroke or hemorrhagic stroke more than ischemic stroke. Patients with stroke may have varied clinical presentations like weakness of limbs, cranial nerve palsies, altered mental status and very rarely as painless loss of vision like our patient.…”

Scorpion Sting: A Hurt to the Heart Reported in a Tertiary Care Hospital in Central Rural India

“…Benzodiazepines are useful as supportive care to decrease painful paraesthesia, which helps alleviate anxiety, and for treatment of myoclonus, opsoclonus, and excessive motor activity in scorpion envenomation [12][13][14]. Angiotensin-converting enzyme inhibitors (oral captopril) were found to be safe and effective in scorpion stings leading to cardiovascular manifestations in a retrospective analysis.…”