Case Report: Organophosphorus Section Poisoning-Induced Intermediate Extrapyramidal Syndrome
Organophosphate (OP) compounds are one of the most common agents used for deliberate self-harm in developing countries, including India. OP compounds inhibit the enzyme acetylcholinesterase, which is responsible for hydrolysing the neurotransmitter acetylcholine in both the central and peripheral...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2023-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/18497/64520_CE[Ra1]_F(IS)_PF1(AkA_OM)_QC(SHK_RDW_IS)_PFA(AKA_KM)_PN(KM).pdf |
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| author | Puneeth M Reddy Karthik CH Reddy |
| author_facet | Puneeth M Reddy Karthik CH Reddy |
| author_sort | Puneeth M Reddy |
| collection | DOAJ |
| description | Organophosphate (OP) compounds are one of the most common agents used for deliberate self-harm in developing countries,
including India. OP compounds inhibit the enzyme acetylcholinesterase, which is responsible for hydrolysing the neurotransmitter
acetylcholine in both the central and peripheral nervous systems (PNS). Acute cholinergic crises are the most common clinical
presentation of OP poisoning. While physicians mostly encounter acute and delayed complications, there have been rare documented
cases in the litreature of an intermediate syndrome presenting with extrapyramidal symptoms such as tremors, rigidity, and dystonia.
In this report, the authors present a case of a 64-year-old male patient who presented to the Emergency Department (ED) with a
history of consuming an unknown quantity of OP-Phorate (11.2%). The initial manifestations included vomiting, sweating, difficulty
in breathing, and a low level of consciousness. The patient was managed with atropine, pralidoxime, and mechanical ventilation.
He was extubated but later reintubated due to respiratory failure. Eventually, a neurological examination revealed rigidity in all four
limbs. The patient was diagnosed with an extrapyramidal type of intermediate syndrome and treated with oral amantadine and
trihexyphenidyl. After further hospital monitoring, the patient was extubated and discharged with intact neurological function. |
| first_indexed | 2024-03-11T17:59:30Z |
| format | Article |
| id | doaj.art-ed8032e58f494654b98b8cdf26054b57 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-03-11T17:59:30Z |
| publishDate | 2023-09-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-ed8032e58f494654b98b8cdf26054b572023-10-17T10:29:50ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2023-09-011709121310.7860/JCDR/2023/64520.18497Case Report: Organophosphorus Section Poisoning-Induced Intermediate Extrapyramidal SyndromePuneeth M Reddy0Karthik CH Reddy1Postgraduate, Department of Emergency Medicine, St. Johns Medical College Hospital Bangluru, Karnataka, India.Associate Professor, Department of Emergency Medicine, St. Johns Medical College Hospital Bangluru, Karnataka, India.Organophosphate (OP) compounds are one of the most common agents used for deliberate self-harm in developing countries, including India. OP compounds inhibit the enzyme acetylcholinesterase, which is responsible for hydrolysing the neurotransmitter acetylcholine in both the central and peripheral nervous systems (PNS). Acute cholinergic crises are the most common clinical presentation of OP poisoning. While physicians mostly encounter acute and delayed complications, there have been rare documented cases in the litreature of an intermediate syndrome presenting with extrapyramidal symptoms such as tremors, rigidity, and dystonia. In this report, the authors present a case of a 64-year-old male patient who presented to the Emergency Department (ED) with a history of consuming an unknown quantity of OP-Phorate (11.2%). The initial manifestations included vomiting, sweating, difficulty in breathing, and a low level of consciousness. The patient was managed with atropine, pralidoxime, and mechanical ventilation. He was extubated but later reintubated due to respiratory failure. Eventually, a neurological examination revealed rigidity in all four limbs. The patient was diagnosed with an extrapyramidal type of intermediate syndrome and treated with oral amantadine and trihexyphenidyl. After further hospital monitoring, the patient was extubated and discharged with intact neurological function.https://jcdr.net/articles/PDF/18497/64520_CE[Ra1]_F(IS)_PF1(AkA_OM)_QC(SHK_RDW_IS)_PFA(AKA_KM)_PN(KM).pdfacute pesticide poisoningatropineextrapyramidal signssuicide |
| spellingShingle | Puneeth M Reddy Karthik CH Reddy Case Report: Organophosphorus Section Poisoning-Induced Intermediate Extrapyramidal Syndrome Journal of Clinical and Diagnostic Research acute pesticide poisoning atropine extrapyramidal signs suicide |
| title | Case Report: Organophosphorus Section Poisoning-Induced Intermediate Extrapyramidal Syndrome |
| title_full | Case Report: Organophosphorus Section Poisoning-Induced Intermediate Extrapyramidal Syndrome |
| title_fullStr | Case Report: Organophosphorus Section Poisoning-Induced Intermediate Extrapyramidal Syndrome |
| title_full_unstemmed | Case Report: Organophosphorus Section Poisoning-Induced Intermediate Extrapyramidal Syndrome |
| title_short | Case Report: Organophosphorus Section Poisoning-Induced Intermediate Extrapyramidal Syndrome |
| title_sort | case report organophosphorus section poisoning induced intermediate extrapyramidal syndrome |
| topic | acute pesticide poisoning atropine extrapyramidal signs suicide |
| url | https://jcdr.net/articles/PDF/18497/64520_CE[Ra1]_F(IS)_PF1(AkA_OM)_QC(SHK_RDW_IS)_PFA(AKA_KM)_PN(KM).pdf |
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