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J Korean Soc Emerg Med > Volume 9(3); 1998 > Article
Journal of The Korean Society of Emergency Medicine 1998;9(3): 465-470.
A Case of Recovery from Suspended Animation caused by Puffer fish Poisoning: a case report
Hee Sig Mun, Seok Woo Kang, Jin Ho Shin, Woo Kyoon Rho, Geun Tae Park, Kyoon Seok Cho, Seung Chan Song, Seong Hee Lee, Byung Chul Yoon, Ho Soon Choi, Choon Suhk Kee, Kyung Nam Park, Min Ho Lee
Tetrodotoxin is a neurotoxin produced by about 90 species of puffer fish and causes paralysis of central nervous system and peripheral nerves by blocking the movement of all monovalent cations. Ingestion of tetrodotoxin produces clinical manifestations such as paresthesias(within 10-45 min), vomiting, lightheadedness, salivation, muscle twitching, dysphagia, difficulty in speaking, convulsion and death that expressed by cardiopulmonary arrest with loss of brain stem reflex sometimes. Tetrodotoxin prevents or delays ischemia induced neuronal death by way of following 3 mechanisms. Firstly, it reduces the energy demand of the brain tissues. Secondly, it delays or even prevents anoxic depolarization. Finally, it diminishes ischemia induced cell swelling and cerebral edema. We report a case of puffer fish poisoning which presented with cardiopulmonary arrest and loss of brain stem reflex, but completely recovered by aggressive cardiopulmonary resuscitation.
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