Abstract
Background
Ciguatera-fish poisoning (or ciguatera) is a common but underdiagnosed food-borne
illness related to fish consumption that is characterized by nausea, vomiting and
neurologic symptoms such as tingling in the fingers or toes.
Objective
We describe the case of a young man who suffered from diarrhea and abdominal pain
after eating raw fish and who also developed severe ataxia with spontaneous downbeat
and perverted head-shaking nystagmus.
Case report
The patient experienced visual fixation suppression failure during the bithermal caloric
test and bilateral smooth-pursuit impairment. Oculomotor findings suggested dysfunction
of the vestibulocerebellum, especially the flocculus.
Conclusion
These findings suggest that both the peripheral and the central nervous systems can
be involved in ciguatera.
Keywords
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References
- Ciguatera fish poisoning and sea surface temperatures in the Caribbean Sea and the West Indies.Toxicon. 2010; 56: 698-710
- Ciguatera.J Toxicol Clin Toxicol. 1993; 31: 1-29
- Neurotoxic marine poisoning.Lancet Neurol. 2005; 4: 219-228
- Neurology of ciguatera.J Neurol Neurosurg Psychiatry. 2001; 70: 4-8
- Features of ciguatera fish poisoning cases in Hong Kong 2004-2007.Biomed Environ Sci. 2008; 21: 521-527
- Mild ciguatera poisoning: case reports with neurophysiological evaluations.Muscle Nerve. 2000; 23: 1598-1603
- The neurology of eye movements.4th edn. Oxford University Press, New York1999
- Experimental observations on postural nystagmus. II. Lesions of the nodulus.Ann Otol Rhinol Laryngol. 1960; 69: 94-114
- Effects of ablation of flocculus and paraflocculus of eye movements in primate.J Neurophysiol. 1981; 46: 878-899
- Isolated perverted head-shaking nystagmus in focal cerebellar infarction.Neurology. 2005; 64: 575-576
- Specific patterns of neuronal connexions involved in the control of the rabbit’s vestibulo-ocular reflexes by the cerebellar flocculus.J Physiol. 1997; 265: 833-854
- Disorders of binocular control of eye movements in patients with cerebellar dysfunction.Brain. 1996; 119: 1933-1950
- Eye movement disorders.Curr Opin Neurol. 1993; 6: 731-737
- Neuro-otological abnormalities in Friedreich’s ataxia.J Neurol Neurosurg Psychiatry. 1994; 47: 26-32
Article info
Publication history
Published online: February 13, 2012
Accepted:
September 28,
2011
Received in revised form:
May 21,
2011
Received:
February 8,
2011
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
