Strychnine: Difference between revisions
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Revision as of 16:22, 22 March 2016
Background
- Strychnine is a highly toxic substance, mimics generalized tetanus
- Antagonizes glycine release, but unlike TS, it has no effect on GABA release
Clinical Features
- Nausea and vomiting
- Opisthotonus while patient 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
Diagnostic Evaluation
- Serum and urine tests for strychnine
Management
- Supportive management
- Benzodiazepines for seizure
Disposition
- All patients should be admitted