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One of the most common vertebrate fish-borne poisoning
Indian ocean, Caribbean, South Pacific
May - August
> 500 fish species involved
Baracuda, parrot fish, red snapper, kingfish, sturgeon
Large size of fish involved
Figure. Worldwide distribution of ciguatera. Gray indicates coral reef regions located between 35° north and 35° south latitudes; darker gray indicates disease-endemic areas of ciguatera; black circle indicates Canary Islands (latitude 28°06′ north, longitude 15°24′ west. Source: refs. 4 and 5.
Figure 1. Saltatory conduction, with the action potential jumping from one node of Ranvier to the nextDifferent channels are distributed unevenly along the axonal membrane: Na + and K + s are in high concentrations at the node and K + f are almost exclusively paranodal. I h (permeable to both K + and Na + ) limits axonal hyperpolarisation, whereas the Na + /K + pump reverses iconic fluxes that may be generated through activity. 8 Na + =Na channels; K + f =fast K channels; K + s =slow K channels; I h =inward rectifier channels.
Botulism GBS Miller Fisher Fever - +/- +/- Pupils Dilated or unreactive Normal Normal Ophthalmoplegia Early Late Present Paralysis Descending Ascending Descending DTR - + + Ataxia - + + Paresthesia - + + CSF protein Normal Elevated Elevated