Electrophysiologic Evaluation of Snake Bite: A Comparative Study

Background: Snake venoms cause human toxicity in the nervous, cardiovascular, and hematological systems.Recent data challenges traditional toxicity concepts and highlights the diverse nature of snake toxins.Therefore, this study aims to compare electrophysiological responses of snake bites.Methods: The study involved 50 patients with a history of neurotoxic snake bites, both male and female, who underwent nerve conduction studies.The study used standard machine equipment, temperature control, distance measurements, and recording of responses.Motor nerve conduction and repetitive nerve stimulation were performed on median and facial nerves using surface electrodes.The amplitude, latency, and velocity of conduction in the nerves were recorded.Results: It is evident that third, fourth, and sixth cranial nerves were commonly involved after neurotoxic snake bite of which third cranial nerve is the commonest and which is predominantly found in krait bite.Ptosis is present in all cases of krait and cobra bites.18 cases presented with opthalmoplegia, out of which 41% are krait bite and 18.2% are cobra bite.Facial muscle weakness was observed in 84% of cases, with 87.2% being krait bites and 72.7% being cobra bites.The pharyngeal reflex was diminished in 89.7% of krait bites and 72.7% in cobra bites.Neck muscle weakness was observed in 16 cases, with 38.5% being krait bites and 9.0% being cobra bites.Most cases required neostigmine therapy for 48-72 hours. Conclusion:The study confirms that early morning flaccid paralysis with ptosis, despite no snake bite history, requires early treatment with ASV and anticholinesterase for neurotoxic snake bites.