Stroke as a rare consequence of scorpion sting and scorpion ingestion: A case report from South East Nigeria

Abstract

Stroke following scorpion stings is rare and potentially fatal. Some case reports have been documented, especially in the Indian subcontinent. There is no published report of stroke as a complication of scorpion envenomation from South East Nigeria. Presented is the profile of an elderly woman with hemorrhagic stroke as a complication of a sting from a scorpion which was killed and thereafter ingested. A review of relevant literature is also made. An 83-year-old woman from a rural community was admitted in August 2011 at the University of Nigeria Teaching Hospital, Enugu with dysphasia, altered sensorium and right hemiparesis occurring 4 h after a scorpion sting to the left leg 2 weeks before presentation. Preceding the neurological deficits she had local pain and restlessness. She was not a known hypertensive or diabetic, but had been stung on two previous occasions by scorpions. It was customary to eat the scorpion if killed which was the case here. Systemic examination was remarkable only for drowsiness with a Glasgow Coma Scale of 11/15, mild right facial nerve palsy with ipsilateral spastic hemiplegia. Brain computed tomography scan done about 4 weeks after the ictus showed features consistent with a left intracerebral hemorrhage. She was managed conservatively and recovered motor functions over 3 weeks necessitating discharge. Since there was no other detectable risk factor, we can conclude that the patient suffered a stroke as a result of the vasculotoxic actions of the scorpion venom.