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Late Onset Polyneuropathy due to Organophosphate (DDVP) Intoxication

Published online by Cambridge University Press:  02 December 2014

Serhan Sevim ,
Mustafa Aktekin ,
Okan Dogu ,
Hakan Ozturk  and
Mustafa Ertas
Serhan Sevim
Affiliation:
Department of Neurology, Mersin University, Faculty of Medicine, Mersin, Turkey
Mustafa Aktekin
Affiliation:
Department of Anatomy, Mersin University, Faculty of Medicine, Mersin, Turkey
Okan Dogu
Affiliation:
Department of Neurology, Mersin University, Faculty of Medicine, Mersin, Turkey
Hakan Ozturk
Affiliation:
Department of Anatomy, Mersin University, Faculty of Medicine, Mersin, Turkey
Mustafa Ertas
Affiliation:
Department of Neurology, Istanbul University, Faculty of Medicine, Istanbul, Turkey
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Abstract:

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Background:

Organophosphate intoxication can cause some well-known life threatening acute neurological complications such as seizures, paralysis, neuromuscular and cardiac conduction disorders. Less often, a predominantly motor and delayed axonal neuropathy can occur. This syndrome is due to inhibition of neuropathy target esterase.

Case Report:

A 30-year-old woman attempted suicide by drinking approximately 1000mg/kg dimethyl-2,2-dichloro vinyl phosphate (DDVP). After a muscarinic and cholinergic syndrome lasting four days, she developed a purely motor distal axonal polyneuropathy on the fifth week after ingestion confirmed by electroneuromyography and sural nerve biopsy. Neurological examination and electroneuromyography revealed a slight recovery at the end of the 21st month.

Conclusion:

This case of late onset polyneuropathy caused by organophosphate intoxication had unusual features such as intact sensory nerves and worse prognosis when compared to previously reported cases.

Résumé:

RÉSUMÉ: Contexte:

L’intoxication par les organophosphorés peut causer des complications neurologiques aiguës pouvant mettre la vie en danger, tells des convulsions, une paralysie, des troubles de conduction neuromusculaires et cardiaques. Plus rarement, une neuropathie à prédominance motrice et axonale peut survenir. Ce syndrome est dû à l’inhibition de la neuropathy target esterase. Observation clinique: Une femme âgée de 30 ans a fait une tentative de suicide par ingestion d’à peu près 1 000mg/kg de 2,2 dichlorovinyl diméthyl phosphate. Suite à un syndrome muscarinique et cholinergique de quatre jours, elle a développé une polyneuropathie axonale distale purement motrice la cinquième semaine après l’ingestion, neuropathie confirmée par électroneuromyographie et biopsie du nerf sural. L’examen neurologique et l’électroneuromyographie ont montré une légère récupération après 21 mois.

Conclusion:

Ce cas de polyneuropathie à début tardif causée par une intoxication par un organophosphoré était caractérisé par des nerfs sensitifs intacts et un pronostic plus sombre que les cas rapportés antérieurement.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 30 , Issue 1 , February 2003 , pp. 75 - 78
Copyright
Copyright © The Canadian Journal of Neurological 2003

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