Introduction: Snake bite is a treatable cause of neuro-muscular paralysis.

Methods: We describe here 3 children who were suspected and treated for snake bite, based on typical symptomatology, and responded dramatically.

Results: The first case is a 9-year-old boy who presented with history of an unknown bite. He developed abdominal pain followed by slurring of speech, ptosis, difficulty in swallowing, and progressive muscular weakness, requiring ventilation. A snake bite was suspected, and anti-snake venom (ASV) was administered along with neostigmine and atropine. He responded dramatically over next 48 hours. Second case is a 13-year-old male, who presented with crampy abdominal pain during midnight, rapidly followed by slurring of speech, ptosis, quadriparesis and respiratory weakness, requiring mechanical ventilation. There was no history of any bite, but two doubtful fang marks were seen. A snake bite was suspected, and he was treated with ASV, along with neostigmine and atropine. Child responded well and improved. Case three is 12-year-old female child who had sudden-onset abdominal pain at midnight, followed by slurring of speech, bilateral ptosis, and weakness of all four limbs. There was no history of snake bite. However, based on our previous experience, a snake bite was suspected. ASV was initiated but had to be stopped due to an allergic reaction. She was given neostigmine and atropine, to which she responded dramatically.

Conclusion: Snake bite should be suspected in children presenting with rapid-onset ptosis, neuro-muscular weakness with slurring of speech and abdominal pain. Prompt administration of ASV and Neostigmine should be considered.

Juhi Gupta
SMS medical College and attached hospitals
India

Pragati Jeenwal
SMS Medical College
India

Richa Choudhary
SMS Medical College
India

R N Sehra
SMS Medical College
India

Pradeep Meena
SMS Medical College
India

Kusum Devpura
SMS Medical College
India