Investigation of the neuromuscular effects of snake envenoming and the role of antivenom as treatment.

This thesis explored several existing knowledge gaps in our understanding of paralysis occurring in humans after snake envenoming. A review of previous studies indicated the absence of high quality clinical evidence on antivenom as a treatment for paralysis. The clinical studies on two Asian neurotoxic snakes showed that the paralysis slowly recovers without responding to antivenom, due to neurotoxins damaging the nerve ends that innervate muscles. The experimental studies showed that some snake neurotoxins acting on muscle cells are likely to cause paralysis in rats but not in humans challenging the validity of the long-established rat model to study paralysis in humans.