Which symptom is more characteristic of scorpion envenomation than a black widow bite?

• A. Roving eye movements
• B. Severe muscle cramps
• C. Target lesion at the bite site
• D. Local numbness only

Answer: (A)

Roving eye movements come from cranial nerve and brainstem involvement caused by scorpion venom, which can produce an autonomic storm and neuromuscular irritability affecting ocular muscles. Black widow venom, by contrast, mainly causes intense muscle cramps and generalized pain from widespread neurotransmitter release, without the typical cranial nerve–eye movement abnormalities. So the presence of roving eye movements is more characteristic of scorpion envenomation than a black widow bite. The other signs—severe muscle cramps (more typical of black widow), a target lesion at the bite site (not typical of either envenomation), and local numbness only (insufficient to explain systemic effects)—don’t distinguish scorpion stings as clearly.