Citation

Achaibar KC, Moore S, Bain PG. Pract. Neurol. 2007; 7(5): 316-322.

Affiliation

Department of Clinical Neurosciences, Imperial College London, UK.

Copyright

(Copyright © 2007, BMJ Publishing Group)

DOI

10.1136/jnnp.2007.129049

PMID

17885270

Abstract

Ciguatera is a form of poisoning that occurs after eating tropical and subtropical ciguatoxic fish. The ciguatoxins are a family of heat stable, lipid soluble cyclic polyether compounds that bind to and open voltage-sensitive Na(+) channels at resting membrane potential, resulting in neural hyperexcitability, as well as swelling of the nodes of Ranvier. The authors describe a 45-year-old man who developed acute gastrointestinal symptoms in Antigua soon after eating red snapper and grouper, potentially "ciguatoxic fish". This was followed by neurological symptoms 24-48 hours later, including temperature reversal (paradoxical dysaesthesia), intense pruritus and increased nociception as a result of a small fibre peripheral neuropathy. The patient's symptoms and small fibre neuropathy improved over a period of 10 months.

Language: en