- In human, the first symptoms occur 10-45 min after ingestion of tetrodotoxin-containing food.
- Initial symptoms include lip and tongue paralysis, followed by facial and extremity paralysis and numbness.
- Other symptoms such as salivation, nausea, vomiting, and diarrhoea with abdominal pain can be developed severely.
- Loss of sensory and motor neuron function from rapid paralysis occurs over 4-24 hours. This is followed by respiratory muscle paralysis. Deep tendon reflexes are preserved early in the course of paralysis.
- Finally, cardiac dysfunction with hypotension and dysrhythmias, central nervous system (CNS) dysfunction (e.g. coma) seizures. And finally, death can occur within 4-6 hrs from respiratory muscle paralysis.