Ciguatera fish poisoning (CFP), also known simply as ciguatera, is a foodborne illness caused by eating reef fish whose flesh is contaminated with certain toxins. Such individual fish are said to be ciguatoxic. Symptoms may include diarrhea, vomiting, numbness, itchiness, sensitivity to hot and cold, dizziness, and weakness. The onset of symptoms varies with the amount of toxin eaten from half an hour to up to two days. The diarrhea may last for up to four days. Some symptoms typically remain for a few weeks to months. Heart difficulties such as slow heart rate and low blood pressure may also occur.The specific toxins involved are ciguatoxin and maitotoxin. They are originally made by a small marine organism, Gambierdiscus toxicus, that grows on and around coral reefs in tropical and subtropical waters. These are eaten by herbivorous fish which in turn are eaten by larger carnivorous fish. The toxins become more concentrated as they move up the food chain. The fish most often implicated include barracuda, grouper, moray eel, amberjack, sea bass, and sturgeon. Diagnosis is based on a persons symptoms together with having recently eaten fish. If a number of those who eat the same fish develop symptoms the diagnosis becomes more likely. If some of the fish they had previously eaten is available this can also be tested to confirm the diagnosis.Preventive efforts include not eating reef fish, not eating high-risk fish such as barracuda, and not eating fish liver, roe, or fish heads.
It is still perfectly possible to open the mouth. Submucous fibrosis. Fracture of the zygomatic arch. Other causes
Acute osteomyelitis
Ankylosis of the TMJ (fibrous or bony)
Condylar fracture or other trauma. Gaucher disease which is caused by deficiency of the enzyme glucocerebrosidase. Giant cell arteritis
Sympathomimetic drugs, such as amphetamine, methamphetamine, MDA, MDMA, MDEA, methylphenidate, ethylphenidate, and related substances. Infection
Local anesthesia (dental injections into the infratemporal fossa)
Needle prick to the medial pterygoid muscle
Oral submucous fibrosis. Radiation therapy to the head and neck. Tetanus, also called lockjaw for this reason
Malignant hyperthermia
Malaria severa
Secondary to neuroleptic drug use
Malignant otitis externa
Mumps
Peritonsillar abscess
Retropharyngeal or parapharyngeal abscess
Seizure
Stroke
Toothache

Diagnostic approach
X-ray/CT scan taken from the TMJ to see if there is any damage to the TMJ and surrounding structures. Treatment
Treatment requires treating the underlying condition with dental treatments, speech therapy for swallowing difficulty and mouth opening restrictions, physical therapy, and passive range of motion devices. Additionally, control of symptoms with pain medications (NSAIDs), muscle relaxants, and warm compresses may be used. Splints have been used. History
Historically, the term trismus was used to describe the early effects of tetany, also called "lockjaw". References


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