Dendrotoxins also called neurotoxins inhibit neurotransmissions by blocking the nerve impulses, in other words, paralyses the nerves. Black mamba (Dendroaspis polylepis) is one of the fastest and deadliest snakes on land, having a maximum speed of 12 miles/hour and 100% mortality without treatment. The clinical representation can vary markedly due to the fact that its venom contains neurotoxins (Dendrotoxins), cardiotoxins and fasiculins. It is basically olive to grey in colour, and is called black mamba due to black colored mouth cavity. Transporting the snake bite victim to medical facility promptly is very important as he will collapse within 45 minutes.
The symptoms range from profuse sweating, salivation, ptosis, bulbar palsy to respiratory arrest and collapse. Early management of the victim can save his life. We present a case of black mamba bite who was brought to hospital. He required ventilator support and anti-snake venom, but it was the use of neostigmine that helped him recover the most. The victim of a black mamba bite soon experiences a tingling sensation in the mouth and limbs, dizziness, erratic heartbeat, double vision, severe confusion, fever, excessive perspiration and lack of muscle control among other symptoms. If the victim does not receive medical attention, symptoms rapidly progress to severe abdominal pain, shortness of breath, shock and paralysis. Eventually, the victim experiences convulsions, cardiac arrest, respiratory arrest, coma and finally, death. In Pakistan it is rarely found anywhere but it is considered to be present in Margallah hills, Changamanga and Northern areas.