Ann Clin Neurophysiol.  2018 Jan;20(1):41-43. 10.14253/acn.2018.20.1.41.

Intermediate syndrome after dermal exposure to organophosphate insecticide

• Lee SB
• Ryu SH
• Park DY
• Park JH
• Kim JY

• KMID: 2403221
• DOI: http://doi.org/10.14253/acn.2018.20.1.41

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.

Keyword

Organophosphate poisoning; Respiratory insufficiency; Cholinergic

MeSH Terms

Mortality
Muscle Weakness
Organophosphate Poisoning
Paralysis
Poisoning
Polyneuropathies
Respiratory Insufficiency
Skin

Figure

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  Fig. 1 Results of a repetitive nerve stimulation test (RNST) applied to the abductor digiti minimi muscle of a 32-year-old man. (A) A 3-Hz RNST elicited a single supramaximal electrical-stimulus-induced repetitive response (arrows). (B) A decremental response to a 30-Hz RNST was recorded.

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