Difference between revisions of "Tetrodotoxin"

(Mechanism of Injury)
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*Supportive care, intubate if concern for progressive paralysis
*Supportive care is mainstay of treatment
*[[Acetylcholinesterase inhibitors]] (e.g. [[neostigmine]])<ref>Tintanelli's</ref>
*May require intubation if concern for progressive paralysis
*[[Acetylcholinesterase inhibitors]] (e.g. [[neostigmine]])
*Admit, may need ICU
*Admit (may need ICU)
==External Links==
==See Also==
==See Also==

Latest revision as of 06:42, 6 March 2019


  • Neurotoxin found in several marine animals (pufferfish, certain angelfish, blue-ringed octopus)
    • Heat-stable toxin not destroyed by washing, freezing or cooking
  • Blocks neuronal action potential by blocking voltage-gated sodium channels
  • Consumption of improperly prepared pufferfish responsible for vast majority of human toxicity (e.g. fugu restaurants)

Mechanism of Injury

  • Tetrodotoxin binds to and blocks fast-gated sodium channels, blocking conduction of nerve signals.

Clinical Features

Onset of symptoms usually within 30 min to 4 hours after eating pufferfish

Differential Diagnosis

Marine toxins, envenomations, and bites


  • Pufferfish can be tested for the toxin, but decision to treat should be based on clinical picture
  • Evaluate for other treatable causes of symptoms



  • Admit (may need ICU)

External Links

See Also