A rare case of common krait envenomation presented with locked-in syndrome masquerading as brain death

Abstract

Krait (elapid snake) bite may be painless, without evidence of flange marks, and the patient is many times unaware of the bite. This may present as unexplained neuroparalysis and deep coma with absent brainstem reflexes, and it may look like brain death. We present a case of such unexplained neuroparalysis who was diagnosed on clinical ground, and the patient was completely recovered with anti-snake venom (ASV) and supportive treatment. A high index of suspicious, background history of the patient and timely empirical ASV therapy can save the patient from a coma with unexplained neuroparalysis from definite death.