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Neurologic Signs of Ciguatera Disease: Evidence of their Persistence

Ciguatoxins exert their effect on the voltage-sensitive sodium channels of the cellular membranes of all excitable tissues. This effect confers to ciguatera disease (CD) its neurologic hallmarks. A prospective study among French Polynesian adults over a two-month period was conducted to characterize and determine the persistence of neurologic symptoms of CD. We compared 47 patients with CD with 125 controls. In the acute phase of the disease, patients had mainly sensory disturbances as detected by an hypoesthesia on the palm of the hand and poorer sway performance compared with controls. Follow-up two months showed improvement of sway performance that eventually reaching control levels. However, for light-touch threshold, even if we observed a decrease threshold towards normal values, more than 50% of patients did not reach normal values 60 days after disease onset. Our results support the existence of neurologic impairments of CD and suggest their persistence for at least two months after onset.

Received April 16, 2007. Accepted for publication May 18, 2007.

Acknowledgments: We thank the participants for their co-operation and Susan Gingras for expert advice on statistical analysis.

Financial support: This study was supported by the Center for Control of Disease.

^* Address correspondence to E. Dewailly, Public Health Research Unit, Laval University Medical Research Center, 945 Avenue Wolfe, 2e Étage, Sainte-Foy, Quebec, Canada G1V 5B3. E-mail: eric.dewailly{at}crchul.ulaval.ca

Authors’ addresses: M.-L. Chateau-Degat and E. Dewailly, Public Health Research Unit, Laval University Medical Research Center, 945 Avenue Wolfe, 2e Étage, Sainte-Foy, Quebec, Canada G1V 5B3. A. Beuter, Victor Segalen Bordeaux 2 University, Bordeaux, France. G. Vauterin, N. L. Nguyen, M. Chinain, T. Darius, A.-M. Legrand, and R. Chansin, Institut Louis Malardé, Tahiti, French Polynesia.