Snakebite is considered as a significant public health problem contributing considerably to morbidity and mortality. A neurotoxic snake bite can present from mild ptosis to complete paralysis with external and internal ophthalmoplegia. Three patients presented in emergency intubated outside with deeply comatose, fixed dilated pupil, and absent doll's eye reflex mimicking as brain dead.
Kasturiratne A, Wickremasinghe AR, de Silva N, Gunawardena NK, Pathmeswaran A, Premaratna R, et al. The global burden of snakebite: A literature analysis and modelling based on regional estimates of envenoming and deaths. PLoS Med 2008;5:e218.
John J, Gane BD, Plakkal N, Aghoram R, Sampath S. Snake bite mimicking brain death. Cases J 2008;1:16.
Warrell DA. WHO/SEARO guidelines for the clinical management of snakebite in the Southeast Asian region. SE Asian J Trop Med Public Health 1999;30:1-85.
Warrell DA. Injuries, envenoming, poisoning, and allergic reactions caused by the animal. In: Warrell DA, Cox TN, Firth JD, Benj J Jr., editors. Oxford Textbook of Medicine. Oxford University Press; 2003. p. 923-45.
Kularatne SA. Common krait (Bungarus caeruleus) bite in Anuradhapura, Sri Lanka: A prospective clinical study, 1996-98. Postgrad Med J 2002;78:276-80.
Wijdicks EF. The diagnosis of brain death. N Engl J Med 2001;344:1215-21.
Azad C, Mahajan V, Jat KR. Locked-in syndrome as a presentation of snakebite. Indian Pediatr 2013;50:695-7.
Dayal M, Prakash S, Verma PK, Pawar M. Neurotoxin envenomation mimicking brain death in a child: A case report and review of literature. Indian J Anaesth 2014;58:458-60.
Prakash S, Mathew C, Bhagat S. Locked-in syndrome in snakebite. J Assoc Physicians India 2008;56:121-2.
