Strychnine: Difference between revisions
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==Background== | ==Background== | ||
Strychnine is a highly toxic | *Strychnine is a highly toxic substance, mimics generalized [[tetanus]] | ||
*Antagonizes glycine release, but unlike TS, it has no effect on GABA release | |||
*Gopher poison classically | |||
==Clinical Features== | ==Clinical Features== | ||
*[[Nausea and vomiting]] | |||
*Opisthotonus while patient remaining alert | |||
*[[Convulsions]] | |||
*Eventually death through asphyxia | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*Black widow spider bite | |||
*Stiff-man syndrome | |||
{{Movement disorder DDX}} | |||
== | {{Jaw spasms DDX}} | ||
==Evaluation== | |||
*Serum and urine tests for strychnine | |||
==Management== | ==Management== | ||
*Supportive management | |||
*[[Benzodiazepines]] for [[seizure]] | |||
==Disposition== | ==Disposition== | ||
*All patients should be admitted | |||
==See Also== | ==See Also== | ||
- | *[[Tetanus]] | ||
== | *[[In-Training Exam Review]] | ||
==References== | |||
<references/> | <references/> | ||
[[Category:Toxicology]] | |||
Latest revision as of 02:27, 24 February 2021
Background
- Strychnine is a highly toxic substance, mimics generalized tetanus
- Antagonizes glycine release, but unlike TS, it has no effect on GABA release
- Gopher poison classically
Clinical Features
- Nausea and vomiting
- Opisthotonus while patient remaining alert
- Convulsions
- Eventually death through asphyxia
Differential Diagnosis
- Black widow spider bite
- Stiff-man syndrome
Movement Disorders and Other Abnormal Contractions
- Chorea
- Neuroleptic malignant syndrome
- Serotonin syndrome
- Hypocalcemia
- Strychnine toxicity
- Acute tetanus
- Parkinson's disease
- Mono amine oxidase inhibitor toxicity
- Phencyclidine toxicity
- Anti-NMDA receptor encephalitis
- Huntington disease
- Wilson's disease
- CVA
- Schizophrenia
- Psychotic agitation
- Dementia
- Lewy body dementia
- Vascular dementia
- Frontotemporal dementia
- Dystonic reaction
- Extrapyramidal reaction
- Torticollis
- Idiopathic movement disorder
Jaw Spasms
- Acute tetanus
- Akathisia
- Conversion disorder
- Drug toxicity (anticholinergic, phenytoin, valproate, carbamazepine)
- Dystonic reaction
- Electrolyte abnormality
- Hypocalcemic tetany
- Magnesium
- Mandible dislocation
- Meningitis
- Peritonsillar abscess
- Rabies
- Seizure
- Strychnine poisoning
- Stroke
- Temporomandibular disorder
- Torticollis
Evaluation
- Serum and urine tests for strychnine
Management
- Supportive management
- Benzodiazepines for seizure
Disposition
- All patients should be admitted