Two hours after eating at a hotel buffet in Hawaii, a 56-year-old man experiences abdominal pain, vomits once, and has one loose stool. Two days later he experiences numbness of his extremities, tongue, and throat.

He finds that cold objects feel hot and hot objects feel cold, and his teeth feel numb and loose. He develops weakness, gait ataxia, and vertigo. He is hospitalized where he has a slow convalescence. Neurological symptoms persist for one month before he is completely well.

What is the likely diagnosis?

A. Ciguatera

B. Scombroid

C. Paralytic Shellfish Poisoning

D. Botulism

E. Staphylococcal food poisoning

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