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June 1982

Ciguatera Poisoning

Author Affiliations

621 Estancia St Caparra Heights San Juan, PR 00920

Arch Neurol. 1982;39(6):387. doi:10.1001/archneur.1982.00510180065028

To the Editor.—  It was with great interest that we read the article by Chretien et al on ciguatera poisoning (Archives 1981;38:783). Being from an area to which this affliction is endemic, we would like to stress several points that may be of interest to other neurologists.Ciguatera poisoning results from ingesting fish containing a heat-stable toxin or toxins presumably produced by several varieties of dinoflagellates. Any species of fish may be implicated and at present there is no practical field test to identify those containing the poison. In this regard some of the natives have improvised an "assay test": they feed their cats the testes and ovaries of the fish before eating the fish themselves. In fact, ciguatoxin is concentrated in these parts of the fish.1The acute stage of the disease is characterized by gastrointestinal (GI) tract symptoms: abdominal cramps, vomiting, and diarrhea. As the toxin is

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