Question

A patient was brought to casualty with seizures. He had multiple episodes and was taking herbal medicines for the same. He was conscious in between the episodes. During the episodes, he had arching of his back. What is the likely cause?

• A. Strychnine
• B. Ricinus
• C. Nerium odorum
• D. Datura

Answer 1

The Correct Option is A

In this scenario, we are deciphering the likely cause of seizures in a patient who experienced multiple episodes while taking herbal medicines. The distinguishing symptom described is the arching of the back during the episodes, otherwise known as opisthotonos. This clinical presentation is essential for the differential diagnosis.

Given the options:

1. Strychnine
2. Ricinus
3. Nerium odorum
4. Datura

Let's analyze the unique properties associated with each:

• Strychnine: It is a well-known toxic plant alkaloid which causes severe and painful convulsions characterized by opisthotonos due to neuronal overactivity and produces generalized seizures. The patient remaining conscious between episodes aligns with strychnine poisoning.
• Ricinus: Generally linked to Ricin, a potent toxin found in castor beans, which primarily causes nausea, vomiting, abdominal pain, and can be fatal. It is not typically associated with opisthotonos or seizures.
• Nerium odorum: Also known as Oleander, it contains cardiac glycosides leading to symptoms like nausea, vomiting, abdominal pain, and cardiac dysrhythmias, rather than opisthotonos.
• Datura: Known for its anticholinergic properties leading to hallucinations, dry mouth, and hyperthermia, but not specifically opisthotonos or the convulsions described.

Considering these options, strychnine emerges as the most plausible cause for the symptoms described, particularly the arching of the back (opisthotonos) during seizure episodes.