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VOLUME 25 , ISSUE 12 ( December, 2021 ) > List of Articles

LETTER TO THE EDITOR

Snakebite Mimicking Brain Death: Bedside Clues

Subramanian Senthilkumaran, Namasivayam Balamurugan, Nanjundan Karthikeyan, Ponniah Thirumalaikolundusubramanian

Keywords : Anti-snake venom, ICU management of snake bite, Neurotoxic snake bite

Citation Information : Senthilkumaran S, Balamurugan N, Karthikeyan N, Thirumalaikolundusubramanian P. Snakebite Mimicking Brain Death: Bedside Clues. Indian J Crit Care Med 2021; 25 (12):1464-1464.

DOI: 10.5005/jp-journals-10071-23851

License: CC BY-NC 4.0

Published Online: 17-12-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Agarwal et al.1 have successfully managed three cases of snakebites who manifested features similar to brain death but were not true brain dead. Most likely these cases might have gone on to a status of locked-in syndrome (LIS). LIS is a status in which there is complete paralysis of voluntary muscles in all parts of the body except for those that control eye movements. Moreover, this condition makes an individual completely mute and paralyzed in a conscious patient.2 In these individuals, communication may be possible through eye movements.

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  1. Agarwal S, Kaeley N, Khanduri S, Kishore N. Brain dead presentation of snake bite. Indian J Crit Care Med 2018;22(7):541–543. DOI: 10.4103/ijccm.IJCCM_318_17.
  2. Senthilkumaran S, Balamurugan N, Nath Jena N, Thirumalai kolundusubramanian P. Locked-in syndrome in post snake bite: can it be unlocked? Trop Doct 2018;48(3):257. DOI: 10.1177/004947 5518755274.
  3. Senthilkumaran S, Balamurugan N, Menezes RG, Thirumalai kolundusubramanian P. Snake bite and brain death-cause for caution? Am J Emerg Med 2013;31(3):625–626. DOI: 10.1016/j.ajem.2012.11.033.
  4. Senthilkumaran S, Ananth C, Menezes RG, Thirumalai kolundusubramanian P. Snake bite and brain death–handle with care. Indian J Anaesth 2015;59(5):333. DOI: 10.4103/0019-5049. 156906.
  5. Sethi PK, Rastogi JK. Neurological aspects of ophitoxemia (Indian krait)–a clinico-electromyographic study. Indian J Med Res 1981;73:269–276. PMID: 7239611
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