Which symptom is most likely to occur after a scorpion sting?

A scorpion sting can lead to a range of symptoms, but the most characteristic and immediate response is often pain and paresthesias at the site of the sting. Pain is typically intense and may radiate beyond the sting site, while paresthesias refer to sensations such as tingling or numbness that can extend into surrounding areas. This combination is a hallmark of envenomation by certain species of scorpions and serves as a significant indicator of the sting's impact.

While local erythema and swelling can certainly occur, they are more typical secondary reactions to the sting rather than immediate symptoms that define the experience of a scorpion sting. The presence of a puncture mark is also common but does not capture the more severe and defining aspects of the scorpion venom's neurotoxic effects. Cranial nerve abnormalities are less commonly associated with typical scorpion stings, as these symptoms represent more severe systemic or neurological effects that may arise in extreme cases or from particular toxic species.

Thus, the most likely symptoms to observe after a scorpion sting are the severe localized pain and paresthesias, which strongly indicate the body's immediate response to the venom.