Stroke as a rare consequence of scorpion sting and scorpion ingestion: A case report from South East Nigeria

Abstract

Stroke following scorpion stings is rare and potentially fatal. Some case reports have been documented, especially in the Indian subcontinent. There is no published report of stroke as a complication of scorpion envenomation from South East Nigeria. Presented is the profile of an elderly woman with hemorrhagic stroke as a complication of a sting from a scorpion which was killed and thereafter ingested. A review of relevant literature is also made. An 83-year-old woman from a rural community was admitted in August 2011 at the University of Nigeria Teaching Hospital, Enugu with dysphasia, altered sensorium and right hemiparesis occurring 4 h after a scorpion sting to the left leg 2 weeks before presentation. Preceding the neurological deficits she had local pain and restlessness. She was not a known hypertensive or diabetic, but had been stung on two previous occasions by scorpions. It was customary to eat the scorpion if killed which was the case here. Systemic examination was remarkable only for drowsiness with a Glasgow Coma Scale of 11/15, mild right facial nerve palsy with ipsilateral spastic hemiplegia. Brain computed tomography scan done about 4 weeks after the ictus showed features consistent with a left intracerebral hemorrhage. She was managed conservatively and recovered motor functions over 3 weeks necessitating discharge. Since there was no other detectable risk factor, we can conclude that the patient suffered a stroke as a result of the vasculotoxic actions of the scorpion venom.

Corneal ulceration following periocular scorpion sting: a case report

“…The most prevalent clinical manifestations of scorpion bites primarily affect vital organs, including the Central Nervous System (CNS), Cardiovascular System (CVS), respiratory system, coagulation cascade, and endocrine system [ 2 , 5 , 6 ]. Although rare, reports also document ophthalmic manifestations such as blindness resulting from brain infarction leading to cortical blindness, Bilateral Optic Neuropathy, Macular Branch Retinal Vein Occlusion (BRVO), and Transient Ophthalmoplegia [ 3 , 7 – 9 ]. Notably, corneal ulceration has been identified as an initial manifestation of scorpion envenomation, representing a novel presentation.…”

Macular Branch Retinal Vein Occlusion as a Rare Complication of Periocular Scorpion Bite: A Case Report and Literature Review

“…Two cases reported blindness as a consequence of brain infarction which leads to cortical blindness. One case presented with blindness without other neurologic symptoms after several episodes of the scorpion bite [3, 8, 9].…”

Cerebrovascular Injury Following Scorpion Sting and Snake Envenomation: A Case Series

“…[10][11][12] Similarly, scorpions such as M. tamulus and Tityus serrulatus have been reported to cause cerebrovascular involvement. [13][14][15] Various mechanisms have been postulated in causing vascular injury. Proteases and hemorragins cause direct damage to the vascular endothelium.…”

“…– 9 Among all the viper envenomations, reports of CVI are the highest among Russel’s viper envenomation 10 12 Similarly, scorpions such as M. tamulus and Tityus serrulatus have been reported to cause cerebrovascular involvement 13 15 Various mechanisms have been postulated in causing vascular injury.…”