Table 3.

Characteristic symptoms of TTX human poisoning modified from Noguchi and Ebesu (2001) [66].

Level	Affected System	Specific Symptoms
1	Neuromuscular	Paresthesia of lips, tongue, and pharynx, taste disturbance, dizziness, headache, diaphoresis, pupillary constriction
	Gastrointestinal	Salivation, hypersalivation, nausea, vomiting, hyperemesis, hematemesis, hypermotility, diarrhea, abdominal pain
2	Neuromuscular	Advanced general paresthesia, paralysis of phalanges and extremities, pupillary dilatation, reflex changes
3	Neuromuscular	Dysarthria, dysphagia, aphagia, lethargy, incoordination, ataxia, floating sensation, cranial nerve palsies, muscular fasciculation
	Cardiovascular/pulmonary	Hypotension or hypertension, vasomotor blockade, cardiac arrhythmias, atrioventricular node conduction abnormalities, cyanosis, pallor, dyspnea
	Dermatologic	Exfoliative dermatitis, petechiae, and blistering
4	Respiratory failure, impaired mental faculties, extreme hypotension, seizures, loss of deep tendon and spinal reflexes