Late onset polyneuropathy due to organophosphate (DDVP) intoxication

Can J Neurol Sci. 2003 Feb;30(1):75-8. doi: 10.1017/s0317167100002493.

Abstract

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 1,000mg/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.

Publication types

  • Case Reports

MeSH terms

  • Action Potentials / physiology
  • Adult
  • Depressive Disorder, Major / complications
  • Depressive Disorder, Major / psychology
  • Dichlorvos / poisoning*
  • Electromyography
  • Electrophysiology
  • Female
  • Humans
  • Insecticides / poisoning*
  • Male
  • Microscopy, Electron
  • Motor Neurons / drug effects
  • Neural Conduction / drug effects
  • Neurons, Afferent / drug effects
  • Polyneuropathies / chemically induced*
  • Polyneuropathies / pathology
  • Polyneuropathies / physiopathology
  • Suicide, Attempted
  • Sural Nerve / pathology

Substances

  • Insecticides
  • Dichlorvos