Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2014 Jun;10(2):229-31.
doi: 10.1007/s13181-013-0373-0.

A case of neurotoxicity following envenomation by the Sidewinder rattlesnake, Crotalus cerastes

Adam R Bosak  1 , Anne-Michelle Ruha, Kimberlie A Graeme
Affiliations
Case Reports

A case of neurotoxicity following envenomation by the Sidewinder rattlesnake, Crotalus cerastes

Adam R Bosak et al. J Med Toxicol. 2014 Jun.

Abstract

Introduction: North American rattlesnake envenomations typically result in local tissue injury and hematologic derangements. Neurotoxicity is uncommon but when present often manifests as fasciculations and paresthesias. Neurotoxicity following Sidewinder (Crotalus cerastes) envenomation has not been previously reported.

Case report: A 56-year-old man bitten on the right foot developed painful paresthesias, weakness and fasciculations of the right lower extremity, and involuntary muscle contractions of the anterior thigh. Local tissue effects and hemotoxicity never developed. The patient was discharged 5 days after the bite with resolution of fasciculations but continued to have right-sided weakness. The snake was identified as a Sidewinder, C. cerastes, by the patient and two independent herpetologists.

Conclusion: This is the first reported case of a Sidewinder rattlesnake envenomation resulting in neurotoxicity.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Leather boot worn by the patient with two penetrating fang marks circled
Fig. 2
Fig. 2
Right foot of patient showing envenomation site (circled) with a small ecchymotic lesion (1 × 0.7 cm) and minimal swelling. He later developed a scab in this area
See this image and copyright information in PMC

References

    1. Clark RF, Williams SR, Nordt SP, et al. Successful treatment of Crotalid-induced neurotoxicity with a new polyspecific Crotalid fab antivenom. Ann Emerg Med. 1997;30:54–57. doi: 10.1016/S0196-0644(97)70111-2. - DOI - PubMed
    1. Jansen PW, Perkin RM, Van Stralen D. Mojave rattlesnake envenomation: prolonged neurotoxicity and rhabdomyolysis. Ann Emerg Med. 1992;21:322–325. doi: 10.1016/S0196-0644(05)80898-4. - DOI - PubMed
    1. Brick JF, Gutmann L, Brick J, et al. Timber rattlesnake venom-induced myokymia: evidence for peripheral nerve origin. Neurology. 1987;37:1545–1546. doi: 10.1212/WNL.37.9.1545. - DOI - PubMed
    1. Lovecchio F, Pizon AF, Wallace KL, et al. Myokymia after snake envenomation in Arizona. Wilderness Environ Med. 2005;16:116–117. doi: 10.1580/1080-6032(2005)16[116:MASEIA]2.0.CO;2. - DOI - PubMed
    1. Richardson WH, Goto CS, Gutglass DJ, et al. Rattlesnake envenomation with neurotoxicity refractory to treatment with crotaline Fab antivenom. Clin Tox. 2007;45:472–475. doi: 10.1080/15563650701338187. - DOI - PubMed

Publication types

Substances

LinkOut - more resources