. 2022 Jun 27;14(7):436. doi: 10.3390/toxins14070436

Table 3.

Brain and nervous-system complications following Viperidae and Lamprophiidae bite: both hemotoxic and neurotoxic venoms.

Complications	Snake Species	Sex/Age	Bite Mark	Other Symptoms	Presuming Venom Components	Outcome	Antivenom/Amount	Ref.
Ischemic stroke	Daboia russelii (Russell’s Viper)	M/18	Foot	Sever pain	Hemotoxin	Recovered with minor complications	IV Antivenom/6 vials	[36]
Ischemic stroke	Daboia russelii (Russell’s Viper)	F/40	Foot	Hypotonia of the limbs	SVMPs, Hemotoxin	Significant ataxia of gait	IV Antivenom/24 vials	[37]
Ischemic Stroke	Daboia russelii (Russell’s Viper)	M/70	Foot	Ptosis, Seizure	Hemotoxin, Neurotoxin	Recovered	IV Antivenom/20 vials	[38]
Ischemic Stroke	Daboia russelii (Russell’s Viper)	M/55	Foot	Ptosis, Speech disturbances	Hemotoxin, Neurotoxin	Recovered	IV Antivenom/35 vials	[38]
Ischemic stroke	Cerastes cerastes (Desert horned viper)	F/5	Foot	Thrombocytopenia, Acute anemia	SVMPs, Hemotoxin, PLA₂	Dead	N/A	[13]
Thalamic and cerebral infarctions	Daboia russelii (Russell’s Viper)	M/55	Foot	N/A	SVMPs, Hemotoxin	Recovered	IV Antivenom/26 vials	[39]
Cerebral infarction	Daboia russelii (Russell’s Viper)	F/27	Foot	Gerstmann’s syndrome	Hemotoxin, Neurotoxin	Recovered	IV Antivenom/Unclear	[40]
Cerebral infarction	Daboia russelii (Russell’s Viper, prediction)	M/50	Foot	Status epilepticus	SVMPs, Hemotoxin	Motor deficit	N/K	[41]
Ischemic brain infarction	Daboia russelii (Russell’s Viper) Mis-identified at beginning	M/43	Foot	Ptosis and ophthalmoplegia	SVMPs, Hemotoxin, Neurotoxin	Dead	IV Antivenom/35 vials	[12]
Cerebral infarction	Cerastes cerastes (Desert horned viper)	F/32	Hand	Tonic-clonic seizures	SVMPs, Hemotoxin, PLA₂	Dead	N/A	[13]
Cerebral infarction	Cerastes cerastes (Desert horned viper)	M/51	Foot	Hemodynamic shock	SVMPs, Hemotoxin, PLA₂	Recovered	N/A	[13]
ADEM	Daboia russelii (Russell’s Viper)	M/36	Foot	Hematemesis and gum bleeding	SVMPs, Hemotoxin	Recovered	IV Antivenom/30 vials	[42]
AHL	Daboia russelii (Russell’s Viper, prediction)	M/44	Foot	Hemorrhagic necrosis	SVMPs, Hemotoxin	Recovered	N/K	[43]
PRES	Cerastes cerastes (Desert horned viper)	F/23	Foot	Reduction in visual acuity	SVMPs, Hemotoxin,PLA₂	Recovered with visual impairment	IV Antivenom/Unclear	[44]
Myokymia	Crotalus oreganus abyssus (Grand Canyon rattlesnake)	M/46	Hand	Pain, swelling, and erythema of his left hand	Hemotoxin, Neurotoxin	Recovered	IV Antivenom/20 vials	[45]
fasciotomy-requiring compartment syndrome	Rattlesnake	W/32	Hand	Somnolent, febrile, suffering of headache, tachypnoea	Hemotoxin, Neurotoxin	Recovered with complications	N/A	[46]
Bilateral ptosis	Crotalus cerastes (sidewinder rattlesnake)	M/56	Foot	Burning and tingling pain	Hemotoxin, Neurotoxin	Recovered	N/A	[47]
Numbness	Lamprophiidae Homoroselaps lacteus (Spotted harlequin snake)	M/Adult	Palm	Slight burning sensation, swelling	SVMPs, PLA₂	Recovered	N/A	[48]
Subcutaneous ecchymoses		M/Adult	Thumb	Swelling	SVMPs, PLA₂	Recovered	N/A	[48]

ADEM: Acute demyelinating encephalomyelitis; AHL: Acute hemorrhagic leukoencephalitis; SVMPs: Snake-venom metalloproteinases; N/A: Not Applied; N/K: Not known; PLA₂: Phospholipase A2; PRES: Posterior reversible encephalopathy syndrome.