Strychnine poisoning

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Strychnine poisoning
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Muscle spasms, seizures, hyperreflexia, opisthotonus, trismus
Complications	Rhabdomyolysis, renal failure, respiratory failure
Onset	Minutes to hours after exposure
Duration	Hours to days
Types	N/A
Causes	Exposure to strychnine
Risks	Handling pesticides, herbal medicine containing strychnine
Diagnosis	Based on clinical presentation and toxicology screen
Differential diagnosis	Tetanus, seizure disorder, hypocalcemia, meningitis
Prevention	Avoid exposure to strychnine
Treatment	Supportive care, benzodiazepines, muscle relaxants, activated charcoal
Medication	N/A
Prognosis	Variable; can be fatal without treatment
Frequency	Rare
Deaths	N/A

Strychnine poisoning is a form of poisoning that occurs due to the ingestion or exposure to strychnine, a highly toxic, colorless, bitter crystalline alkaloid used as a pesticide, particularly for killing small vertebrates such as birds and rodents. Strychnine poisoning is characterized by severe, painful muscle spasms and convulsions, which can lead to death through asphyxiation or exhaustion.

Sources of Strychnine

Strychnine is derived from the seeds of the Strychnos nux-vomica tree, which is native to India and Southeast Asia. It has been historically used in medicine and as a performance-enhancing drug in small doses, but its use is now limited due to its high toxicity.

Mechanism of Action

Strychnine acts as a neurotoxin by inhibiting the action of the neurotransmitter glycine in the central nervous system. Glycine normally acts to inhibit motor neurons, and its inhibition by strychnine leads to unchecked muscle contractions and convulsions. The toxin primarily affects the spinal cord and the brainstem.

Symptoms

The symptoms of strychnine poisoning typically appear within 15 to 60 minutes of exposure and include:

• Severe muscle spasms and convulsions
• Stiffness of the neck and back
• Hyperreflexia
• Opisthotonus (severe arching of the back)
• Trismus (lockjaw)
• Respiratory failure
• Cyanosis (bluish discoloration of the skin due to lack of oxygen)
• Death due to asphyxiation or exhaustion

Diagnosis

Diagnosis of strychnine poisoning is primarily clinical, based on the characteristic symptoms and history of exposure. Laboratory tests can confirm the presence of strychnine in the blood, urine, or gastric contents.

Treatment

Treatment of strychnine poisoning is supportive and symptomatic. It includes:

• Immediate gastric lavage or administration of activated charcoal to prevent further absorption of the toxin
• Administration of benzodiazepines or barbiturates to control convulsions
• Mechanical ventilation in cases of respiratory failure
• Intravenous fluids and supportive care

Prognosis

The prognosis of strychnine poisoning depends on the dose and the promptness of treatment. With rapid and appropriate medical intervention, the chances of survival increase significantly. However, severe cases can result in long-term neurological damage or death.

Prevention

Preventing strychnine poisoning involves careful handling and storage of strychnine-containing products, using protective equipment, and adhering to safety guidelines. Public awareness and education about the dangers of strychnine are also crucial.

See also

• Poisoning
• Neurotoxin
• Pesticide
• Convulsion
• Respiratory failure