Unusual features in a case of snakebite, presumably due to a Cape cobra (Naja nigricollis).

A case of snakebite, thought to be due to a Cape cobra, in a young girl is described. Unusual features were a protracted period of paralysis and severe neurological residua in the form of hemiparesis and impaired vision. The ophthalmological features started as a bilateral optic neuritis and progressed to bilateral optic atrophy. It is difficult to ascribe all these effects to the neurotoxins of the Cape cobra as the neurotoxic features usually resolve rapidly if the patient survives. The actions of the neurotoxins, the quantity of antivenom to be administered in cases of cobra bite and the possible use of anticholinesterases such as neostigmine in these cases are also discussed.