Reporting on Adverse Clinical Events

Abstract

A prospective observational study in an academic hospital evaluated 23 patients (aged 13-40 years) with acute organophosphate ingestion for delayed neurological effects. Once the cholinergic crisis was treated and resolved, the patients were followed for an additional 6 months for neurologic toxicity. All but one patient had a normal neurological examination hospital discharge. The median hospitalization duration was 6 days. During the 6-month follow-up period, approximately 35% (n = 8) of the patients developed delayed neuropathy associated with organophosphate exposure. Three patients developed symptomatic neuropathy, including persistent foot drop, gait ataxia, and distal paresthesia. A total of 5 patients exhibited subclinical peripheral nerve involvement as assessed in nerve conduction studies. None of the baseline characteristics in this group were predictive of delayed neurological effects. Based on a small observational study, the authors concluded that delayed nerve involvement may occur after recovery from a cholinergic crisis in patients exposed to organophosphate poisoning. Organophosphates [Organophosphates] Pannu AK et al (A Bhalla, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, 4th Floor, F Block, Nehru Hospital, PGIMER, Chandigarh 160012, India; e-mail: bhalla.chd@gmail.com) Organophosphate induced delayed neuropathy after an acute cholinergic crisis in self-poisoning. Clin Toxicol (Phila) 59:488–492 (Jun) 2021