Strychnine: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
*generalized tetanus | *generalized [[Acute tetanus|tetanus]] | ||
*Black widow spider bite | *Black widow spider bite | ||
*stiff-man syndrome | *stiff-man syndrome | ||
{{Jaw spasms DDX}} | |||
==Workup== | ==Workup== | ||
Revision as of 00:03, 16 February 2015
Background
Strychnine is a highly toxic sabustance, it mimics generalized tetanus.It antagonizes glycine release, but unlike TS, it has no effect on GABA release.
Clinical Features
- nausea and vomiting
- opisthotonus while Pt. remaining alert
- convulsions
- eventually death through asphyxia
Differential Diagnosis
- generalized tetanus
- Black widow spider bite
- stiff-man syndrome
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
Workup
serum and urine tests for strychnine
Management
- supportive management
- benzo for seizure
Disposition
- all patients should be admitted
See Also
Sources
rosen, 7th edition p1684