Abstract

DEL-BRUTTO, Victor J.  and  DEL-BRUTTO, Oscar H.. Neurological Complications Of Spider Bites. Rev Ecuat Neurol [online]. 2017, vol.26, n.1, pp.35-39. ISSN 2631-2581.

Spiders are venomous arthropods with worldwide distribution. Most spider bites are clinically insignificant, as the size of their chelicerae is too small to inject enough amount of venom to human beings. Despite this, there are hundreds of reported cases of human envenoming related to spider bites. While clinical manifestations related to spider-bite envenoming are pleomorphic, three main clinical syndromes could be recognized: latrodectism, loxoscelism, and funnel-web spider envenoming. Latrodectism is caused by the potent neurotoxin (-latrotoxin present in the venom of widow spiders (Latrodectus sp.). Most cases present with severe pain at the site of the bite, with arterial hypertension being the most frequent systemic manifestation. Neurological complications mostly consist of headache, lethargy, irritability, generalyzed myalgia, tremor, fasciculations, ataxia, or paresthesias. The latter manifestations are related to an exhaustive release of cholinergic neurotransmitters at the neuromuscular junction. Loxoscelism is caused by envenoming by spiders of the family Sicariidae, genera Loxosceles and Sicarius. It presents in two different forms, cutaneous (with changes restricted to the affected skin) area and viscerocutaneous. In the latter, a severe coagulopathy may occur, associated or not with acute renal failure, jaundice, fever, multi-organ failure and shock. The venom of fennel-web spiders have potent neurotoxins, called (-atracotoxins, that stimulates neurotransmitter release from the presynaptic vesicle, causing hyperstimulation of post-synaptic receptors resulting in sensory disturbances and muscle paralysis. Also, sympathetic and parasympathetic manifestations, including diaphoresis, hypersalivation, arterial hypotension, and cardiac arrhythmias may occur.

Keywords : Spider bites; latrodectism; loxoscelismo; envenoming..

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