Organophosphate induced Delayed
نویسنده
چکیده
Organophosphorus compounds are common insecticidal agents used in India. Their use as a suicidal agent is also well known often leading to massive organophosphorus-compound intoxication. Although uncommon, delayed neurotoxicity has been consistently reported in literature probably related to the inhibition of neurotoxic esterase. This mechanism is implicated not only in damaging peripheral nervous sytem but also in causing central processes leading to Myelopathy. We describe a patient who had a classic acute cholinergic crisis after exposure to organophosphates, with the subsequent development of organophosphateinduced delayed neuropathy. Magnetic resonance imaging (MRI) showed diffuse spinal cord atrophy that persisted long after the cholinergic effects had subsided. Keyword :Chloropyriphos, Organophosphorus, Delayed Myelopathy, pure motor, peripheral nervous system CASE REPORT: An 18-year-old girl attempted suicide by drinking 100 ml of a mixture containing Chloropyriphos 50% ( O,O-diethyl O-3,5,6trichloropyridin-2-yl phosphorothioate) and Cypermethrin 5% a synthetic Pyrethroids which acts as an axonic poison. She developed classical features of organophosphate poisoning with loss of consciousness, pin-point pupils and profuse oral secretions. She was treated with gastric lavage, atropine infusion and other supportative measures. She did not require ventilation and over the next one week made an uneventful recovery and was discharged without any neurological deficits. The patient was asymptomatic over the next 2 months after which she developed progressive spasticity of both lower limbs which progressed over the next 4 months and since then has remained static. Currently, she is independent for almost all her ADLs except walking for which she requires one person support. Clinically she had features of bilateral pyramidal tract involvement in the lower limbs (spasticity, brisk deep ten-
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Severe Organophosphate Poisoning with Delayed Cholinergic Crisis, Intermediate Syndrome and Organophosphate Induced Delayed Polyneuropathy on Succession
Organophosphate compounds are the organic derivatives of Phosphorous containing acids and their effect on neuromuscular junction and Autonomic Synapses is clinically important. After exposure these agents cause acute and sub acute manifestations depending on the type and severity of the agents like Acute Cholinergic Manifestations, Intermediate Syndrome with Nicotinic features and Delayed Centr...
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