Nerve Changes Occur After Organophosphate Poisoning

Recovery also preceded by changes in nerve activity

THURSDAY, July 17 (HealthDay News) -- Intermediate syndrome (IMS), or muscle paralysis or weakness caused by organophosphates found in pesticides and nerve agents, is associated with distinct changes in nerve activity that improve with recovery, according to an article published online July 15 in PLoS Medicine.

Pradeepa Jayawardane, from the University of Peradeniya in Sri Lanka, and colleagues studied 78 Sri Lankan patients with symptomatic organophosphate poisoning. Patients were treated with atropine and pralidoxime, received a neurological exam daily, and assessed by repetitive nerve stimulation of the right and left median ulnar nerves daily until all abnormalities were resolved.

The researchers diagnosed 10 patients with IMS, while another 30 were diagnosed with an incomplete variant of IMS. IMS was associated with a series of electrophysiological changes, which could be correlated with the progression of muscle weakness, and electrophysiological improvements occurred before clinical recovery.

"These data help to document the existence of IMS as a clinical entity," Cynthia K. Aaron, M.D., from Children's Hospital of Michigan in Detroit, writes in an accompanying editorial. "If these distinctive electrophysiological changes are subsequently validated in further studies, they should lead to improved diagnostic and prognostic tools for clinical use in organophosphate-poisoned patients."

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