Strychnine: Difference between revisions
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==Background== | ==Background== | ||
*Strychnine is a highly toxic substance, mimics generalized tetanus | *Strychnine is a highly toxic substance, mimics generalized [[tetanus]] | ||
*Antagonizes glycine release, but unlike TS, it has no effect on GABA release | *Antagonizes glycine release, but unlike TS, it has no effect on GABA release | ||
*Gopher poison classically | |||
==Clinical Features== | ==Clinical Features== | ||
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
*Black widow spider bite | *Black widow spider bite | ||
*Stiff-man syndrome | *Stiff-man syndrome | ||
{{Movement disorder DDX}} | |||
{{Jaw spasms DDX}} | {{Jaw spasms DDX}} | ||
== | ==Evaluation== | ||
*Serum and urine tests for strychnine | *Serum and urine tests for strychnine | ||
| Line 28: | Line 29: | ||
==See Also== | ==See Also== | ||
*[[Tetanus]] | *[[Tetanus]] | ||
*[[In-Training Exam Review]] | |||
==References== | ==References== | ||
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