Damage to the Median and Ulnar Nerves After a Snake Bite

About 5 million people are bitten by snakes every year, resulting in more than 2 million cases of envenoming and 20,000–125,000 deaths. Most of these cases occur in Asia, Africa, South America, and the Indo Pacific. Muscle weakness caused by preor postsynaptic toxins acting on the neuromuscular junction and rhabdomyolysis and ischemic or hemorrhagic strokes are the most common neurological complications of snake bite. Local signs of envenomation are more prominent after viper and colubrid bites, but may also occur in cases of elapid bites and include swelling, blister formation, and necrosis of the skin and subcutaneous tissue. Peripheral nerve damage is a rare complication of snake bite. Neuroma-in-continuity represents one of the worst complications of peripheral nerve lesions because of pain and poor recovery. We report a case of median and ulnar nerve necrosis leading to ultrasound feature of a double neuroma-incontinuity after cobra snakebite to the forearm.