Amnesic Shellfish Poisoning - Symptoms and Treatment

Symptoms and Treatment

In the brain, domoic acid especially damages the hippocampus and amygdaloid nucleus. It damages the neurons by activating AMPA and kainate receptors, causing an influx of calcium. Although calcium flowing into cells is a normal event, the uncontrolled increase of calcium causes the cell to degenerate. See reviews by Ramsdell (2007) and Pulido (2008).

Gastrointestinal symptoms can appear 24 hours after ingestion of affected molluscs. They may include vomiting, nausea, diarrhea, abdominal cramps and haemorrhagic gastritis. In more severe cases, neurological symptoms can take several hours or up to three days to develop. These include headache, dizziness, disorientation, vision disturbances, loss of short-term memory, motor weakness, seizures, profuse respiratory secretions, hiccoughs, unstable blood pressure, cardiac arrhythmia and coma.

People poisoned with very high doses of the toxin or displaying risk factors such as old age and renal failure can die. Death has occurred in 4 of 107 confirmed cases. In a few cases, permanent sequelae included short-term memory loss and peripheral polyneuropathy.

There is no known antidote available for domoic acid, so if symptoms fit the description, it is advised to go quickly to the hospital. Cooking or freezing affected fish or shellfish tissue does not lessen the toxicity.

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