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Seok-Yong Ryu 1 Article
Neurotoxic Shellfish Poisoning after Ingesting Whelk
Young-Gil Ko, Ji-Young Ahn, Seok-Yong Ryu, Sang-Lae Lee, Suk-Jin Cho, Mi-Ran Kim
J Korean Soc Clin Toxicol. 2006;4(2):147-150.   Published online December 31, 2006
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Neurotoxic shellfish poisoning (NSP) can result from eating filter-feeding shellfish carrying brevetoxins produced by the marine dinoflagellate Krenia brevis (formally Gymnodinium breve). Brevetoxins enhance sodium entry into cells via voltage-sensitive sodium channels and have an excitatory effect. The incubation period is three hours (range 15 minutes-18 hours). NSP is characterized by gastroenteritis combined with neurologic symptoms. Gastrointestinal (GI) symptoms include abdominal pain, nausea, diarrhea and burning pain in the rectum. Neurologic symptoms are paresthesia, reversal of hot and cold temperature sensation, myalgia, headache, vertigo, and ataxia. Other symptoms may include malaise, tremor, dysphagia, bradycardia, decreased reflexes, dilated pupils, seizure, and coma. The health problem caused by K. breviscan be associated with a red tide bloom. We encountered 3 cases of neurotoxic shellfish poisoning. They all presented with GI and neurologic symptoms andrecovered after conservative treatment.

JKSCT : Journal of The Korean Society of Clinical Toxicology