Intermediate syndrome after dermal  exposure to organophosphate insecticide

Lee, Su Bin; Ryu, Seung Ho; Park, Doo Yong; Park, Jong-Ho; Kim, Jee Young

doi:2018.20.1.41

Ann Clin Neurophysiol > 2018 January;20(1) > Article
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Ann Clin Neurophysiol. 2018; 20(1): 41-43. Published online January 31, 2018. doi: https://doi.org/10.14253/acn.2018.20.1.41

Intermediate syndrome after dermal exposure to organophosphate insecticide

Su Bin Lee, Seung Ho Ryu, Doo Yong Park, Jong-Ho Park, and Jee Young Kim

Department of Neurology, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea

Corresponding Author: Jee Young Kim ,Tel: +82-31-810-6130 , Fax: +82-31-969-0500 , Email: nrkjy55@gmail.com

Received June 13, 2017 Revised: November 19, 2017 Accepted December 7, 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Intermediate syndrome (IMS) typically occurs at 24–96 hours following organophosphate (OP) poisoning, after an acute cholinergic crisis, but before OP-induced delayed polyneuropathy. It is characterized by proximal muscle weakness and respiratory insufficiency, which is a major contributing factor of OP-related morbidity and mortality. We report an atypical IMS case showing rapid-onset ascending paralysis and respiratory disturbance with an acute cholinergic crisis occurring 4–5 days after skin exposure to OP.

Key words: Organophosphate poisoning; Respiratory insufficiency; Cholinergic