The underlying mechanism of scorpion venom peptide BmK AS in reducing epilepsy seizures: mediated through dual modulation of Nav1.6 and the inflammasome pathway

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  The underlying mechanism of scorpion venom peptide BmK AS in reducing epilepsy seizures: mediated through dual modulation of Nav1.6 and the inflammasome pathway Abstract Introduction:  Voltage-gated sodium channel (VGSC) dysregulation, particularly of the Nav1.6 subtype, is a core mechanism underlying epileptogenesis and its associated neuropsychiatric comorbidities. The scorpion venom peptide BmK AS has demonstrated anticonvulsant potential, but its efficacy in chronic epilepsy and the precise mechanisms of action remain undefined. Methods:  Here, we show that BmK AS exerts robust anti-epileptic and neuroprotective effects through converging mechanisms. In a kainic acid-induced mouse model, BmK AS treatment reduced mortality and seizure parameters. Electrophysiological studies assessed BmK AS modulation of VGSC subtypes. The functional relevance of Nav1.6 targeting was confirmed by the loss of BmK AS’s anti-seizure efficacy upon its pharmacological blockade in a PTZ-in...

Successful management of third-trimester scorpion envenomation (Parabuthus maximus) in a resource-limited setting: A case report

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Successful management of third-trimester scorpion envenomation (Parabuthus maximus) in a resource-limited setting: A case report  

BACKGROUND 

Scorpion envenomation in pregnancy is a rare but potentially fatal obstetric emergency, with limited evidence on optimal management and antivenom safety. Neurotoxic venom induces autonomic storms, threatening maternal cardiovascular stability and uteroplacental perfusion, which can lead to fetal distress or demise. 

CASE SUMMARY 

A 31-year-old gravida 4, para 3 woman at 36 weeks’ gestation presented 30 minutes after a confirmed Parabuthus maximus sting to her right foot. She manifested systemic envenomation, including agitation, profuse sweating, tachycardia (142 bpm), and hypertension (168/102 mmHg). Cardiotocography revealed fetal tachycardia (175-180 bpm). A multidisciplinary team initiated intravenous morphine, midazolam, and species-specific antivenom (South African Vaccine Producers Polyvalent Scorpion Antivenom), resulting in the resolution of maternal and fetal symptoms within 12 hours. Critically, antivenom was administered within 40 minutes of the sting, which likely contributed to the rapid reversal of the catecholamine surge. A key factor enabling this rapid and targeted response was the patient’s action of capturing the scorpion, allowing for precise species identification. The pregnancy progressed uneventfully to term, culminating in an uncomplicated vaginal delivery of a healthy infant. 

CONCLUSION 

This case illustrates that scorpion envenomation in late pregnancy poses a dual threat to both maternal and fetal well-being. Prompt recognition, continuous fetal monitoring, and the very early administration of antivenom-buttressed by multidisciplinary care-can avert catastrophic outcomes. This case provides supporting evidence that antivenom can be safe and effective during the third trimester, even in resource-constrained environments. Public education on safe first aid, including bringing the scorpion for identification, is essential.

Omullo FP. Successful management of third-trimester scorpion envenomation (Parabuthus maximus) in a resource-limited setting: A case report. World J Clin Cases 2026; 14(2): 114762 [DOI: 10.12998/wjcc.v14.i2.114762]