ijcmcr International Journal of Clinical & Medical Case Reports 2834-250X International Journal of Clinical & Medical Case Reports Case report Pseudo–Brain Death After Neurotoxic Snakebite: A Case Report Thakur Priyanka Clinical and Medical Science, India 16 01 2026 7 2 23122025 08012026 © 2026 The Author(s). Published by International Journal of Clinical & Medical Case Reports. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0).

Snakebite envenomation remains a major public health problem in tropical regions [1,4] and can rarely present with severe neuroparalysis mimicking brain death. Neurotoxic bites, particularly from elapid snakes, contain α- and β-neurotoxins that disrupt neuromuscular transmission, leading to descending paralysis, bulbar involvement, and respiratory failure. In severe cases, paralysis may cause absent brainstem reflexes, a phenomenon referred to as pseudo–brain death [7-9]. Such presentations are diagnostically challenging, especially when patient history is unclear and neuroimaging, EEG, and CSF analysis are normal. We report a case of a 34-year-old male presenting with unexplained coma and absent brainstem reflexes, who showed complete neurological recovery following empirical administration of anti-snake venom (ASV) and supportive care. This case highlights the importance of high clinical suspicion for neurotoxic envenomation in patients with unexplained coma, even in the absence of local signs or clear history.