16 December, 2014

Involuntary limb twitching after ingestion of scorpion-based Chinese medicine

Scorpions are known to be used in traditional Chinese cousin and medicine. The most used species is the butid Mesobuthus martensii (Karsch, 1879), which is commercially bred in farms in China.

Lam and co-workers now report about a man compalining about chest pain, dizziness, and generalised tremors 15 minutes after ingestion of a teaspoon of herbal powder with water. The powder was made of scorpions (M. martensii).

After ruling out other potential causes, the diagnosis of this case was compatible with neurotoxicity associated with the consumption of M. martensii powder, even though it could not be directly confirmed by chemical analysis.

Mesobuthus martensii Karsch, commonly known as the Chinese scorpion or Manchurian scorpion, has been used in traditional Chinese medicine as Quanxie to treat chronic pain, tetanus, tremors, convulsion, and paralysis for more than a thousand years. We report a case of poisoning after ingestion of a teaspoon of Quanxie powder. The patient presented with chest pain, dizziness, diaphoresis, generalised involuntary limb twitching, and hypertonia around 15 minutes post-ingestion. The patient recovered uneventfully after supportive management. Intravenous diazepam appeared to be effective in alleviating limb twitching. Failure to accurately measure the dose and to boil before consumption may have contributed to his clinical toxicities.

Lam PK, Wong TW, Chan YC, Mak TW. Generalised involuntary limb twitching after ingestion of Mesobuthus martensii Karsch (Quanxie) powder. Hong Kong Med J. 2014 Dec;20(6):552-5. [Free full text]

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