Electromyographic and laboratory findings in acute Solanum torvum poisoning

Robert L. Glover, Nicholas J. Connors, Cristiana Stefan, Ernest Wong, Robert S. Hoffman, Lewis S. Nelson, Mark J. Milstein, Silas W. Smith, Michael L. Swerdlow

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Context: Solanum torvum berries, known as susumber or Turkey berries, are prepared as part of traditional Jamaican dishes usually served with cod and rice. Poisoning is rare. Although toxic compounds have never been definitively isolated, previous reports suggest toxicity results from inhibition of acetylcholinesterases. We present a case of susumber berry poisoning with detailed electromyographic studies and laboratory analysis.Case details: A 54-year-old woman presented to the Emergency Department (ED) complaining of vision, speech, and gait changes; emesis; and diffuse myalgias following consumption of susumber berries. The physical examination demonstrated an intact, lucid mental status, miosis, opsoclonus, severe dysarthria, dysmetria, mild extremity tenderness and weakness, and inability to ambulate. Her symptom constellation was interpreted as a stroke.Discussion: Electromyography demonstrated a pattern of early full recruitment as well as myotonia during the period of acute toxicity. Additionally, solanaceous compounds, in particular solasonine and solanidine, were identified in leftover berries and the patients serum. Store-bought commercial berries and subsequent serum samples were free of such toxic compounds. EMG studies, together with a laboratory analysis of berries or serum can assist in the differential diagnosis of stroke, and provide both a prognostic screening and confirmation of suspected glycoside toxicity.

Original languageEnglish (US)
Pages (from-to)61-65
Number of pages5
JournalClinical Toxicology
Volume54
Issue number1
DOIs
StatePublished - Jan 2 2016

Fingerprint

Solanum
Poisoning
Toxicity
Fruit
Poisons
Electromyography
Acetylcholinesterase
Glycosides
Screening
Serum
Stroke
Myotonia
Miosis
Ocular Motility Disorders
Gadiformes
Dysarthria
Cerebellar Ataxia
Myalgia
Gait
Physical Examination

Keywords

  • Electromyography
  • solanum torvum
  • susumber berries

ASJC Scopus subject areas

  • Toxicology

Cite this

Glover, R. L., Connors, N. J., Stefan, C., Wong, E., Hoffman, R. S., Nelson, L. S., ... Swerdlow, M. L. (2016). Electromyographic and laboratory findings in acute Solanum torvum poisoning. Clinical Toxicology, 54(1), 61-65. https://doi.org/10.3109/15563650.2015.1110749

Electromyographic and laboratory findings in acute Solanum torvum poisoning. / Glover, Robert L.; Connors, Nicholas J.; Stefan, Cristiana; Wong, Ernest; Hoffman, Robert S.; Nelson, Lewis S.; Milstein, Mark J.; Smith, Silas W.; Swerdlow, Michael L.

In: Clinical Toxicology, Vol. 54, No. 1, 02.01.2016, p. 61-65.

Research output: Contribution to journalArticle

Glover, RL, Connors, NJ, Stefan, C, Wong, E, Hoffman, RS, Nelson, LS, Milstein, MJ, Smith, SW & Swerdlow, ML 2016, 'Electromyographic and laboratory findings in acute Solanum torvum poisoning', Clinical Toxicology, vol. 54, no. 1, pp. 61-65. https://doi.org/10.3109/15563650.2015.1110749
Glover RL, Connors NJ, Stefan C, Wong E, Hoffman RS, Nelson LS et al. Electromyographic and laboratory findings in acute Solanum torvum poisoning. Clinical Toxicology. 2016 Jan 2;54(1):61-65. https://doi.org/10.3109/15563650.2015.1110749
Glover, Robert L. ; Connors, Nicholas J. ; Stefan, Cristiana ; Wong, Ernest ; Hoffman, Robert S. ; Nelson, Lewis S. ; Milstein, Mark J. ; Smith, Silas W. ; Swerdlow, Michael L. / Electromyographic and laboratory findings in acute Solanum torvum poisoning. In: Clinical Toxicology. 2016 ; Vol. 54, No. 1. pp. 61-65.
@article{9d6b6461990446e18ca84edf8dda9609,
title = "Electromyographic and laboratory findings in acute Solanum torvum poisoning",
abstract = "Context: Solanum torvum berries, known as susumber or Turkey berries, are prepared as part of traditional Jamaican dishes usually served with cod and rice. Poisoning is rare. Although toxic compounds have never been definitively isolated, previous reports suggest toxicity results from inhibition of acetylcholinesterases. We present a case of susumber berry poisoning with detailed electromyographic studies and laboratory analysis.Case details: A 54-year-old woman presented to the Emergency Department (ED) complaining of vision, speech, and gait changes; emesis; and diffuse myalgias following consumption of susumber berries. The physical examination demonstrated an intact, lucid mental status, miosis, opsoclonus, severe dysarthria, dysmetria, mild extremity tenderness and weakness, and inability to ambulate. Her symptom constellation was interpreted as a stroke.Discussion: Electromyography demonstrated a pattern of early full recruitment as well as myotonia during the period of acute toxicity. Additionally, solanaceous compounds, in particular solasonine and solanidine, were identified in leftover berries and the patients serum. Store-bought commercial berries and subsequent serum samples were free of such toxic compounds. EMG studies, together with a laboratory analysis of berries or serum can assist in the differential diagnosis of stroke, and provide both a prognostic screening and confirmation of suspected glycoside toxicity.",
keywords = "Electromyography, solanum torvum, susumber berries",
author = "Glover, {Robert L.} and Connors, {Nicholas J.} and Cristiana Stefan and Ernest Wong and Hoffman, {Robert S.} and Nelson, {Lewis S.} and Milstein, {Mark J.} and Smith, {Silas W.} and Swerdlow, {Michael L.}",
year = "2016",
month = "1",
day = "2",
doi = "10.3109/15563650.2015.1110749",
language = "English (US)",
volume = "54",
pages = "61--65",
journal = "Clinical Toxicology",
issn = "1556-3650",
publisher = "Informa Healthcare",
number = "1",

}

TY - JOUR

T1 - Electromyographic and laboratory findings in acute Solanum torvum poisoning

AU - Glover, Robert L.

AU - Connors, Nicholas J.

AU - Stefan, Cristiana

AU - Wong, Ernest

AU - Hoffman, Robert S.

AU - Nelson, Lewis S.

AU - Milstein, Mark J.

AU - Smith, Silas W.

AU - Swerdlow, Michael L.

PY - 2016/1/2

Y1 - 2016/1/2

N2 - Context: Solanum torvum berries, known as susumber or Turkey berries, are prepared as part of traditional Jamaican dishes usually served with cod and rice. Poisoning is rare. Although toxic compounds have never been definitively isolated, previous reports suggest toxicity results from inhibition of acetylcholinesterases. We present a case of susumber berry poisoning with detailed electromyographic studies and laboratory analysis.Case details: A 54-year-old woman presented to the Emergency Department (ED) complaining of vision, speech, and gait changes; emesis; and diffuse myalgias following consumption of susumber berries. The physical examination demonstrated an intact, lucid mental status, miosis, opsoclonus, severe dysarthria, dysmetria, mild extremity tenderness and weakness, and inability to ambulate. Her symptom constellation was interpreted as a stroke.Discussion: Electromyography demonstrated a pattern of early full recruitment as well as myotonia during the period of acute toxicity. Additionally, solanaceous compounds, in particular solasonine and solanidine, were identified in leftover berries and the patients serum. Store-bought commercial berries and subsequent serum samples were free of such toxic compounds. EMG studies, together with a laboratory analysis of berries or serum can assist in the differential diagnosis of stroke, and provide both a prognostic screening and confirmation of suspected glycoside toxicity.

AB - Context: Solanum torvum berries, known as susumber or Turkey berries, are prepared as part of traditional Jamaican dishes usually served with cod and rice. Poisoning is rare. Although toxic compounds have never been definitively isolated, previous reports suggest toxicity results from inhibition of acetylcholinesterases. We present a case of susumber berry poisoning with detailed electromyographic studies and laboratory analysis.Case details: A 54-year-old woman presented to the Emergency Department (ED) complaining of vision, speech, and gait changes; emesis; and diffuse myalgias following consumption of susumber berries. The physical examination demonstrated an intact, lucid mental status, miosis, opsoclonus, severe dysarthria, dysmetria, mild extremity tenderness and weakness, and inability to ambulate. Her symptom constellation was interpreted as a stroke.Discussion: Electromyography demonstrated a pattern of early full recruitment as well as myotonia during the period of acute toxicity. Additionally, solanaceous compounds, in particular solasonine and solanidine, were identified in leftover berries and the patients serum. Store-bought commercial berries and subsequent serum samples were free of such toxic compounds. EMG studies, together with a laboratory analysis of berries or serum can assist in the differential diagnosis of stroke, and provide both a prognostic screening and confirmation of suspected glycoside toxicity.

KW - Electromyography

KW - solanum torvum

KW - susumber berries

UR - http://www.scopus.com/inward/record.url?scp=84951566675&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84951566675&partnerID=8YFLogxK

U2 - 10.3109/15563650.2015.1110749

DO - 10.3109/15563650.2015.1110749

M3 - Article

C2 - 26577583

AN - SCOPUS:84951566675

VL - 54

SP - 61

EP - 65

JO - Clinical Toxicology

JF - Clinical Toxicology

SN - 1556-3650

IS - 1

ER -