Amnesic Shellfish Poisoning (ASP)

 

Toxin: domoic acid

 

Timing:

(1) median onset 5 – 6 hours after ingestion (ranges from 15 minutes to 38 hours)

(2) duration 24 hours up to 12 weeks

 

Presenting symptoms:

(1) nausea and vomiting

(2) abdominal pain

 

Severity of Syndrome	Symptoms
mild to moderate	diarrhea
	headache
	memory loss
	mutism
severe	hemiparesis
	ophthalmoplegia
	coma
	seizures
	hypotension
	cardiac arrhythmias

 

Mortality rate: about 4%, with the elderly at increased risk.

 

If more than one person was exposed, the spectrum of findings amongst all of the persons may help reach a final diagnosis.

 

The differential diagnosis would include other forms of food poisoning, especially botulism.

 

Management:

(1) Severely affected patients require intensive care.

(2) Seizures may require anticonvulsants.