tetrodotoxication

poisoning caused by eating tetrodotoxic fishes. Symptoms usually develop 10-45 minutes after ingestion and include stiffness of lips and tongue, tingling of the extremities which changes to numbness, hypersalivation, sweating, extreme weakness, precordial pain, headache, subnormal temperature, decreased blood pressure and a rapid weak pulse. Nausea, vomiting, diarrhoea, and epigastric pain may appear. Respiratory distress, blueness of the skin, and extensive muscular paralysis ensue. The fatality rate is about 59%, death usually taking place between 6 and 24 hours. There is no known antidote and treatment is purely symptomatic. Emetics, laxatives and enemas have been found useful. Artificial respiration is the most important therapeutic measure and should be applied along with pentylenetrazol