In this case, gastrointestinal and neurological symptoms predominate. In addition, formation of toxic aerosols by wave action can produce respiratory asthma-like symptoms. No deaths have been reported and the syndrome is less severe than ciguatera, but nevertheless debilitating. Unlike ciguatera, recovery is generally complete in a few days. Symptoms are purely neurological and their onset is rapid.
Duration of effects is a few days in non-lethal cases.
Symptoms include tingling, numbness, and burning of the perioral region, ataxia, giddiness, drowsiness, fever, rash, and staggering. The most severe cases result in respiratory arrest within 24 hours of consumption of the toxic shellfish. If the patient is not breathing or if a pulse is not detected, artificial respiration and CPR may be needed as first aid. There is no antidote, supportive therapy is the rule and survivors recover fully.