Dorvalina Silva M, Resende L A, Kimuni Ueda A, Barraviera B, Mendes R P, Montenegro M R
Departamentos de Neurologia, Moléstias Infecciosas e Patologia da Faculdade de Medicina de Botucatu, UNESP, Brasil.
Arq Neuropsiquiatr. 1996 Mar;54(1):1-11.
We studied 6 patients and 2 dogs that have been bitten by South American rattlesnake Crotalus durissus terrificus and one rabbit inoculated with crotalid venom. We analyzed sensory and motor peripheral nerve conduction, repetitive stimulation for studying neuromuscular transmission and electromyographies. Muscle biopsies were processed by histochemistry. All patients had peripheral mononeuropathy of the closest sensitive nerve to the area of snakebite. The neuromuscular transmission alterations were minimal. Muscle histochemistry of 4 patients, 2 dogs and 1 rabbit showed findings of mitochondrial myopathy. The majority of authors admit that crotalid venom causes myastenic syndrome. Our findings suggest that palpebral ptosis, myastenic facies and muscular weakness observed after crotalid poisoning are, probably, due to transient and reversible mitochondrial myopathy. As far as we know, this is the first report on the ability of the venom of this rattlesnake to cause local sensitive mononeuropathy and the first muscle histochemistry showing mitochondrial myopathy in humans poisoned by crotalid venom.
我们研究了6名被南美响尾蛇(Crotalus durissus terrificus)咬伤的患者、2只狗以及1只接种了响尾蛇毒液的兔子。我们分析了感觉和运动外周神经传导、用于研究神经肌肉传递的重复刺激以及肌电图。肌肉活检采用组织化学方法处理。所有患者均有蛇咬伤部位附近最接近的感觉神经的外周单神经病。神经肌肉传递改变最小。4名患者、2只狗和1只兔子的肌肉组织化学显示出线粒体肌病的表现。大多数作者承认响尾蛇毒液会导致肌无力综合征。我们的研究结果表明,响尾蛇中毒后出现的上睑下垂、肌无力面容和肌肉无力,可能是由于短暂且可逆的线粒体肌病所致。据我们所知,这是关于这种响尾蛇毒液导致局部感觉单神经病能力的首次报告,也是首次在响尾蛇毒液中毒的人类中显示出线粒体肌病的肌肉组织化学报告。