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The greater black krait (Bungarus niger), a newly recognized cause of neuro-myotoxic snake bite envenoming in Bangladesh by Md Abul Faiz, Aniruddha Ghose,

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Presentation on theme: "The greater black krait (Bungarus niger), a newly recognized cause of neuro-myotoxic snake bite envenoming in Bangladesh by Md Abul Faiz, Aniruddha Ghose,"— Presentation transcript:

1 The greater black krait (Bungarus niger), a newly recognized cause of neuro-myotoxic snake bite envenoming in Bangladesh by Md Abul Faiz, Aniruddha Ghose, Md Farid Ahsan, Md Ridwanur Rahman, Md Robed Amin, Md Mahtab Uddin Hassan, Md A. Wahed Chowdhury, Ulrich Kuch, Thalita Rocha, John B. Harris, R. David G. Theakston, and David A. Warrell Brain Volume 133(11):3181-3193 October 28, 2010 © The Author (2010). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

2 Case 1: forty-year-old male 23 h after being bitten by a greater black krait (B. niger, Fig. 2), showing generalized flaccid paralysis requiring mechanical ventilation and myoglobinuria. Md Abul Faiz et al. Brain 2010;133:3181-3193 © The Author (2010). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

3 Greater black krait (B. niger). Md Abul Faiz et al. Brain 2010;133:3181-3193 © The Author (2010). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

4 Case 5: site of envenoming. Md Abul Faiz et al. Brain 2010;133:3181-3193 © The Author (2010). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

5 Case 5: minimal ptosis, 5 h after the bite. Md Abul Faiz et al. Brain 2010;133:3181-3193 © The Author (2010). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

6 Case 5: right lateral rectus palsy 5 h after the bite (low resolution stills from video). Md Abul Faiz et al. Brain 2010;133:3181-3193 © The Author (2010). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

7 Transverse sections of soleus muscles of rats stained with haematoxylin and easin. Md Abul Faiz et al. Brain 2010;133:3181-3193 © The Author (2010). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

8 (A) At nerve muscle junctions of control soleus muscles, synaptic vesicles in the nerve terminals were labelled with anti-synaptophysin IgG (green) and acetylcholine receptors were labelled with TRITC-conjugated α-bungarotoxin (red). Md Abul Faiz et al. Brain 2010;133:3181-3193 © The Author (2010). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

9 Combined labelling of synaptophysin and neurofilament (green) and junctional acetylcholine receptor (red) at neuromuscular junctions in longitudinal cryosections of soleus muscles of rats. Md Abul Faiz et al. Brain 2010;133:3181-3193 © The Author (2010). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

10 Ultrastructural changes to terminal innervation in soleus muscles exposed in vivo to the venom of B. niger. Md Abul Faiz et al. Brain 2010;133:3181-3193 © The Author (2010). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

11 Greater black krait (B. niger). Md Abul Faiz et al. Brain 2010;133:3181-3193 © The Author (2010). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

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