Neurologic shellfish poisoning

The cockle, Austrovenus stutchburyi from New Zealand contained brevetoxin Bi (225) [230] and the greenshell mussel, Pema canaliculus contained brevetoxin B3 (226) [231]. A further brevetoxin analogue, brevetoxin B2 (227) was isolated from the hepatopancreas of P. canaliculus [232], while the major toxin in neurological shellfish poisoning (NSP) associated with P. canaliculus was identified as brevetoxin B4 (228) [233]. 

Paralytic shellfish poisoning caused by saxitoxins presents with both gastrointestinal and neurologic symptoms. Five to 30 min after consumption of contaminated mollusks, there is a slight perioral tingling progressing to numbness that spreads to the face and neck. Other symptoms include headache, dizziness, nausea, vomiting, rapid pain, and anuria. In severe cases, there is the onset of severe... 

Long RR, Sargent JC, Hammer K. Paralytic shellfish poisoning a case report and serial electrophysi-ologic observations. Neurology 40 1310-1312, 1990. 

On the basis of the patients recall of portion sizes and analysis of unconsumed portions of mussels, it was possible to estimate the exposure to domoic acid in nine patients and one person who did not become iU. Increasing exposure correlated with the clinical course of events. All patients reported gastrointestinal illness, but only one of six patients who consumed between 60 and 110 mg domoic acid suffered memory loss, and none required hospitalization. All three patients who had consumed 270-290 mg domoic acid suffered neurological symptoms and were hospitalized. One person who consumed only 20 mg domoic acid did not become iU. The cognitive impairment observed in this new disease, attributed to domoic acid, appeared to be persistent and led to the term amnesic shellfish poisoning [1,158]. 

Amnesic shellfish poisoning The main toxin associated with ASP is the tricarboxylic amino acid domoic acid (Figure 2), responsible for a human intoxication characterized by a widespread neurological dysfunction, chronic loss of memory, and motor neuropathy. The potent neurotoxic actions of domoic acid are due to the activation of a subtype (non-NMDA) of glutamate neurotransmitter receptors, and the subsequent depolarization leading to seizures and neuronal death. 

Observations in humans Neurotoxic shellhsh poisoning (NSP) associated with consumption of shellfish comprise oysters and clams, in addition to other hlter feeders [3]. Those intoxicated, developed symptoms like nausea, diarrhea, and abdominal pain, in addition to one or several neurological symptoms (paresthesia, vertigo, and lack of coordination). The onset of NSP symptoms is between minutes and a few hours. There are no reports of fatalities associated with NSP, but some patients have needed respiratory support. The NSP symptoms are reported to resolve few days after the intake of infested shellhsh. 

G. breve and G. ftreve-contaminated shellfish and found to cause a neurological poisoning similar... 

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