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Jamaican Susumber Berry Poisoning Mimicking Acute Stroke.
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Cerebrovascular diseases (Basel, Switzerland)
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2022-10-25
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1
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7
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525686.pdf
Adobe PDF, 192.95 KB
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Abstract
Background: Stroke mimics are non-vascular conditions that present with acute focal neurological deficits, simulating an acute ischemic stroke. Susumber berry (SB) toxicity is a rare cause of stroke mimic with limited case reports available in the literature.
Objectives: We report four new cases of SB toxicity presenting as stroke mimic, and we performed a systematic review.
Methods: MEDLINE/EMBASE/WoS were searched for "susumber berries," "susumber," or "solanum torvum."
Results: 531 abstracts were screened after removal of duplicates; 5 articles and 2 conference abstracts were selected describing 13 patients. A total of 17 patients who ingested SB and became ill were identified, including our 4 patients. All but one presented with acute neurologic manifestation; 16 (94%) presented with dysarthria, 16 (94%) with unstable gait, 8 (47%) with nystagmus/gaze deviation, 10 (59%) with blurry vision, and 5 (29%) with autonomic symptoms. Six (35%) required ICU admission, and 3 (18%) were intubated. Fourteen (82%) had a rapid complete recovery, and 3 were hospitalized up to 1 month.
Conclusions: SB toxicity can cause neurological symptoms that mimic an acute stroke typically with a posterior circulation symptom complex. Altered SB toxins (from post-harvest stressors or temperature changes) might stimulate muscarinic/nicotinic cholinergic receptors or inhibit acetylcholinesterase, causing gastrointestinal, neurological, and autonomic symptoms. In cases of multiple patients presenting simultaneously to the ED with stroke-like symptoms or when stroke-like symptoms fail to localize, a toxicological etiology (such as SB toxicity) should be considered.
Citation
Tamaiev J, Trebach J, Rosso M, Moriarty J, DiSalvo P, Biary R, Su M, Perk J, Levine SR. Jamaican Susumber Berry Poisoning Mimicking Acute Stroke. Cerebrovasc Dis. 2022 Oct 25:1-7. doi: 10.1159/000525686. Epub ahead of print. PMID: 36282075.