Twelve patients with severe neuroparalytic snake envenomation were admitted to the intensive care unit
with respiratory failure over one year period. Initially, ptosis and ophthalmoplegia, followed by bulbar
palsy and respiratory muscle weakness were the common sequelae. All of them received cardiorespiratory
support with mechanical ventilation, anti-snake venom (median dose of 20 vials), and
anticholinesterase therapy. Most survived with complete neurological recovery. So, good outcome in
such cases is related to early cardiorespiratory support and anti-venom therapy.
Key words: anticholinesterase, envenomation, polyvalent anti-snake venom
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