A potentially lethal neurotoxin-producing scorpion, Centruroides sculpturatus, exists in the southwestern United States. The most common symptoms of envenomation of 24 patients included local pain, restlessness, and roving eye movements. In this series 80% of cases were in children less than 10 years of age. Pain at the site of the sting was a predominant symptom in the patient more than 10 years of age; however, extreme and perpetual restlessness was the most common symptom in the younger patient. The diagnosis in children is usually made by clinical presentation alone since the site of the sting cannot be identified and children may not communicate the history of the sting. The most commonly used chemotherapeutic agent is phenobarbital. There is no evidence, however, that this drug decreases morbidity or mortality, and massive doses of phenobarbital were associated with two respiratory arrests in this series. The nature of scorpions and their venoms is discussed. Research is needed regarding the use of sympathetic blocking agents in scorpion envenomation.

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