Rehabilitation of Organophosphate Induced Delayed Polyneuropathy

Sahoo, Pabitra Kumar; Mohamed, Faiz; Sahu, Mamata Manjari; Ganesh, Shankar

doi:10.4172/2329-9096.1000481

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…The results showed significant improvement, with the upper limbs nearly returning to normal and some residual deficits in the lower limbs, which could improve over time. These results were seen at follow-up after two years, three years, and seven months, respectively, for three cases, therefore demonstrating that rehabilitative therapy and good nursing care can improve the effects of neuropathy [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

The Enigma of Delayed Neurotoxicity in Organophosphate Poisoning: A Case Report of Clinical Presentation With Normal MRI Findings

Chhabra,

Oberoi,

Pandita

et al. 2024

Cureus

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Organophosphates (OP) are the most widely used pesticides globally and are misused for suicides because of their easy availability. It leads to functional impairment of distal segments of sensory and motor axons of peripheral nerves, as well as impacting the ascending and descending spinal tracts. It progresses through latent, progressive, static, and improvement phases. In the improvement phase, peripheral nerve regeneration occurs, revealing the spinal cord lesion with myelopathic features. The acute symptoms and treatments of OP poisoning have been extensively documented in the literature. Delayed neurotoxicity is a rare but debilitating condition that can manifest weeks after initial exposure. A high index of suspicion for OP-induced delayed neurotoxicity should be maintained in patients presenting with delayed neurological symptoms post-OP exposure, even with normal MRI findings. OP linked to delayed neuropathy include triorthocresyl phosphate, chlorpyriphos, malathion, fipronil, mipafox, matriphonate, and parathion. Among these, the most hazardous OP ester is tri-o-cresyl phosphate. We report a case of a 28-year-old male who developed neurotoxicity five weeks following OP poisoning with chlorpyrifos. Early diagnosis and symptomatic management are important for improving patient outcomes.

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Section: Discussionmentioning

confidence: 99%

The Enigma of Delayed Neurotoxicity in Organophosphate Poisoning: A Case Report of Clinical Presentation With Normal MRI Findings

Chhabra,

Oberoi,

Pandita

et al. 2024

Cureus

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“…Patients with intermediate syndrome or organophosphate-induced delayed polyneuropathy should be addressed symptomatically because there is presently no cure for either condition 14 . According to a long-term follow-up study, rehabilitation therapy combined with appropriate nursing care has been demonstrated to improve the disease 15 .…”

Section: Clinical Discussionmentioning

confidence: 99%

Wallerian degeneration in the brain after organophosphorus poisoning: a case report

Gajurel¹,

Giri

Poudel

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and Importance: The type, quantity, and potency of the organophosphorus compound (OPC) taken determine the symptoms of OPC poisoning as well as their severity. The exact etiology for organophosphorus (OP) poisoning delay neuropathy regulating Wallerian degeneration is still unknown. Case Presentation: We report here a rare case of a 25-year-old lady with Wallerian degeneration in the brain found in an MRI in a patient after OPC ingestion. MRI of the brain, in our case, shows Wallerian degeneration of the corona radiata, internal capsule, and midbrain. Clinical Discussion: Some OPCs can lead to OP-induced delayed neuropathy, a form of delayed neurotoxicity in humans (OPIDN). The distal axonopathy’s (in OPIDN) morphological pattern resembles Wallerian degeneration, which happens in vitro following nerve damage. Although delayed Wallerian degeneration from organophosphate poisoning often affects the peripheral nervous system, it can also affect the central nervous system. Rehabilitation therapy combined with appropriate nursing care has been demonstrated to improve the disease. Conclusion: Central nervous system involvement after OP poisoning is rare, and MRI of the brain and spinal cord can document evidence of Wallerian degeneration after OP poisoning.

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“…3 Rehabilitative therapy along with proper nursing care has shown to improve the condition from a long-term follow-up study. 19 Corticosteroids have also been used as a neuroprotective drug in OPIDN. 20 In our case, the patient was treated with intravenous methylprednisolone and extensive physiotherapy of the lower limbs.…”

Section: Discussionmentioning

confidence: 99%

Delayed myelopathy after organophosphate intoxication: A case report

Gautam

Sapkota

Ojha

et al. 2022

SAGE Open Medical Case Reports

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Organophosphate-induced delayed neuropathy, a central-distal axonopathy, passes through latent, progressive, static and improvement phases. During the improvement phase, the peripheral nerves regenerate unmasking the spinal cord lesion with myelopathic features. We report a case of a 16-year-old male who developed myelopathy 6 weeks following chlorpyrifos poisoning. He had a motor weakness of 4/5 in bilateral hips and 3/5 in bilateral knees and ankles. Spasticity and exaggerated reflexes with ankle clonus were present in the lower limbs. Sensory and the upper limb motor examinations were all normal. Pertinent blood, cerebrospinal fluid and nerve conduction tests were normal. Magnetic resonance imaging of the spine showed features of cord atrophy. Three months following physiotherapy, his power improved to 5/5 in bilateral knee and hip joints and 4/5 in bilateral ankles with spasticity. Organophosphate-induced delayed neuropathy can present as earlier as 6 weeks with myelopathy. Previous history of organophosphorous exposure is important in myelopathy or peripheral neuropathy.

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Rehabilitation of Organophosphate Induced Delayed Polyneuropathy

Cited by 3 publications

References 2 publications

The Enigma of Delayed Neurotoxicity in Organophosphate Poisoning: A Case Report of Clinical Presentation With Normal MRI Findings

The Enigma of Delayed Neurotoxicity in Organophosphate Poisoning: A Case Report of Clinical Presentation With Normal MRI Findings

Wallerian degeneration in the brain after organophosphorus poisoning: a case report

Delayed myelopathy after organophosphate intoxication: A case report

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