Organophosphate Induced Delayed Neuropathy: A Case Report
Journal Title: International Journal of Contemporary Medical Research - Year 2016, Vol 3, Issue 8
Abstract
Introduction: Acute organophosphorous poisoning is one of the most common poisonings that we come across in emergency medicine producing significant mortality and morbidity. The sinister spectrum of organophosphorous poisoning is not only related to an initial life threatening acute cholinergic crisis but also to the delayed neurological symptoms which can be potentially debilitating. Accidental or suicidal exposure with these anticholinesterase compounds results in three well defined syndromes i.e. initial acute cholinergic crisis, intermediate syndrome (12-96 hours after exposure) and a organophosphorous induced delayed neuropathy (3-4 weeks after initial exposure). Case report: Herein we describe a 22 year old male patient who after ingestion of large amount of (250 ml) Chlorpyriphos based insecticide had an acute cholinergic crisis and intermediate syndrome followed by development of paraesthesia and lower limb weakness 3 weeks after initial exposure to organophosphorous. Pyramidal tract involvement was also observed as the patient developed spastic paraparesis in lower limbs. Electrophysiological study was characterized by motor axonal polyneuropathy. Conclusion: This was a case of organophosphate induced delayed polyneuropathy with Corticospinal tract involvement leading to spastic paraparesis. Hence all patients with organophosphorous poisoning should be under regular follow up and examined for neurological involvement.
Authors and Affiliations
Praneet Ansal Mundu, Rajendra Prasad Satapathy, Manish Kumar, J. K. Mitra
Keywords
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