Guidelines on the diagnosis and management of solitary plasmacytoma of bone and solitary extramedullary plasmacytoma.

BACKGROUND

The aim was to study the incidence, clinical manifestations, and prognosis of neurological complications secondary to scorpion envenomation.

MATERIAL/

METHODS

A retrospective study over a 13-year period including all patients admitted to our ICU for scorpion envenomation.

RESULTS

During the period of study, 951 patients were admitted due to scorpion envenomation. Mean age was 14.7+/-17.4 years, ranging from 0.5 to 90 years. Neuromuscular signs were observed in 739 patients (78%), coma (Glasgow Coma Score 12) in 15.4% of cases, and convulsions in 6%. The other neurological signs observed were: agitation in 709 patients (74.6%), squint in 119 patients (12.5%), bilateral miosis in 43 patients (5%), and a bilateral mydriasis in 16 patients (1.7%). Brain CT was performed in 10 patients, these being abnormal in 90% of cases. In our study the presence of coma (p<0.001), convulsions (p<0.001), bilateral miosis (P<0.001), and the presence of bilateral mydriasis (P<0.001) correlated with poor outcome.

CONCLUSIONS

Neurological manifestations were often observed in severe scorpion-envenomed patients and they correlated with poor outcome. Their mechanisms are complex. Prevention is highly warranted.