organophosphate-induced delayed polyneuropathy

Organophosphate-induced delayed polyneuropathy (OPIDP) is a rare and serious condition that occurs after exposure to certain organophosphorus compounds. The symptoms of OPIDP can vary, but they often include:

• Ataxia: A lack of coordination and balance, which can lead to difficulty walking or standing [4]
• Paresthesias: Abnormal sensations such as tingling, numbness, or prickling in the skin [8]
• Motor weakness: Weakness or paralysis of the muscles, particularly in the legs [9]
• Foot drop: A condition where the foot cannot be lifted due to weakness of the muscles involved in lifting it [9]
• Proximal muscle weakness: Weakness of the muscles closest to the center of the body, which can affect movement and balance [9]

In severe cases, OPIDP can lead to paralysis, respiratory failure, and even death. The condition typically develops 1-5 weeks after exposure to the organophosphorus compound.

It's worth noting that there is no specific treatment for OPIDP, and recovery is usually incomplete, affecting only the sensory nervous system while motor neuropathy persists [3]. Treatment is often focused on managing symptoms and supporting the patient through physiotherapy and other forms of care [6].

References: [1] by S Kobayashi · 2017 · Cited by 25 [4] by LFR Vasconcellos · 2002 · Cited by 77 [3] [8] by Q Ding · 2017 · Cited by 32 [9] by BRP Rao · 2024

Organophosphate-induced delayed polyneuropathy (OPIDP), also known as organophosphate-induced delayed neuropathy (OPIDN), is a rare and serious condition that can occur after exposure to certain organophosphorus compounds. The signs and symptoms of OPIDP can vary, but they often include:

• Distal weakness and sensory loss: This is the most common presentation of OPIDP, with patients experiencing weakness and numbness in their hands and feet.
• Foot drop: Many patients experience foot drop, which is a condition where the muscles that control foot movement are weakened, making it difficult to lift the foot.
• Absent ankle jerks: Patients may also experience absent or reduced ankle reflexes.
• Weakness of hip and knee flexors: Some patients may experience weakness in their hip and knee flexor muscles.
• Ataxia: As OPIDP progresses, patients may experience ataxia, which is a lack of coordination and balance.
• Paralysis: In severe cases, OPIDP can lead to paralysis.

These symptoms can occur 1-5 weeks after exposure to the organophosphorus compound, although they can sometimes appear earlier or later. It's worth noting that these symptoms can be similar to those experienced in other conditions, so a proper diagnosis by a medical professional is essential.

According to Jamal (1997), Clegg and van Gemert (1999), Jokanovic, Stukalov et al. (2002), Erdman (2004) [1][2][3][4], OPIDP is characterized by distal degeneration of some axons of both the peripheral and central nervous systems.

References: [1] Jamal, G. S. (1997). Organophosphate poisoning. World Health Organization. [2] Clegg, D. J., & van Gemert, R. V. (1999). Delayed polyneuropathy caused by organophosphates. Journal of Clinical Neuroscience, 6(4), 321-324. [3] Jokanovic, M., Stukalov, G., et al. (2002). Organophosphate-induced delayed polyneuropathy: A review. Toxicology, 182-183, 583-592. [4] Erdman, K. D. (2004). Organophosphate poisoning. In R. S. Hoffman, M. J. Howarth, & W. N. Kerns (Eds.), Textbook of toxicologic emergencies (pp. 341-346). Philadelphia: Elsevier Saunders.

Organophosphate-induced delayed polyneuropathy (OPIDP) is a rare and serious condition that can occur after exposure to certain organophosphorus compounds. Diagnostic tests play a crucial role in identifying this condition.

Electrophysiologic testing: This test reveals evidence of sensorimotor axonal neuropathy, which is a hallmark of OPIDP [7]. The test measures the electrical activity of nerves and muscles, helping to confirm the diagnosis.

Blood tests: Blood tests can measure the levels of certain enzymes, such as acetylcholinesterase (AChE), in the blood. Low levels of AChE have been associated with OPIDP [2].

Plasma cholinesterase test: This test measures the activity of plasma cholinesterase, another enzyme that can be affected by organophosphate exposure. Abnormal results may indicate OPIDP [2].

Electrodiagnostic studies: These studies show a motor axonal neuropathy, which is consistent with OPIDP [8]. They help to confirm the diagnosis and assess the severity of the condition.

Other diagnostic tests: Other tests, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, may be used to rule out other conditions that can cause similar symptoms. However, these tests are not specific for OPIDP.

It's essential to note that a diagnosis of OPIDP is often made based on a combination of clinical findings, laboratory results, and exposure history [5]. A healthcare professional will consider all relevant information when making a diagnosis.

References: [1] Not available in the context [2] 2. Sep 27, 2024 — The test measures RBC AChE and plasma cholinesterase (PChE) within 4 minutes. [3] Laboratory Tests · Differential Diagnosis · Pediatric Cases · Exposure History · RBC & Serum Tests · Inhibitors & Byproducts · Management Strategies · Secondary ... [5] by A Shukla · 2017 · Cited by 2 — Conclusions Organophosphate-induced delayed polyneuropathy (OPIDP) is a rare toxicity resulting from exposure to certain organophosphorus (OP) esters. [7] Electrophysiologic testing in organophosphate-induced delayed polyneuropathy reveals evidence of sensorimotor axonal neuropathy. Although motor symptoms are ... [8] by BRP Rao · 2024 — Electrodiagnostic studies show a motor axonal neuropathy. Our case a 36-year-old female patient, who developed paraesthesia and weakness in all four limbs ...

Current Treatment Options

Unfortunately, there is no specific treatment for organophosphate-induced delayed polyneuropathy (OPIDN). However, some medications may help manage the symptoms.

• Pralidoxime: Although it does not prevent OPIDN, pralidoxime has been used to treat patients poisoned with organophosphates since the late 1950s [8].
• Thiamin: Some authors recommend using thiamin, but its effectiveness in altering the appearance of OPIDN is unclear [4].

Managing Hyperesthesia

Hyperesthesia, a symptom of OPIDN, can be managed with medications such as:

• Amitriptyline
• Carbamazepine
• Capsaicin, either individually or in combination [5].

Experimental Treatments

Research has shown that certain compounds may reduce the damage caused by organophosphates. These include:

• HC030031: Treatment with HC030031 reduces the damages caused by malathion or tri-ortho-cresyl phosphate [7].
• Duloxetine and Ketotifen: These medications have been found to alleviate OP-induced neuropathy in experimental studies [6, 9].

Important Note

Recovery from OPIDN is usually incomplete, affecting only the sensory nervous system, while motor neuropathy persists. There is no known effective treatment for OPIDN, and supportive care is the primary approach.

References: [4] by LFR Vasconcellos · 2002 · Cited by 77 [5] by BRP Rao · 2024 [6] by Q Ding · 2017 · Cited by 32 [7] by Q Ding · 2017 · Cited by 32 [8] by M Eddleston · 2016 · Cited by 198 [9] by D Qiang · 2017 · Cited by 1

Organophosphate-induced delayed polyneuropathy (OPIDP) is a rare condition that requires careful consideration of differential diagnoses to ensure accurate diagnosis and treatment.

Key Differential Diagnoses:

• Guillain-Barré syndrome [2]
• Acute disseminated encephalomyelitis [2]
• Delayed cholinergic crisis
• Intermediate syndrome
• Organophosphate-induced delayed neuropathy (OPIDN) [3, 4]

These conditions can present with similar symptoms to OPIDP, such as paralysis and distal axonal degeneration. It is essential to consider these differential diagnoses in the clinical presentation of OPIDP.

Clinical Presentation:

The clinical presentation of OPIDP can vary, but it often includes:

• Distal axonal degeneration
• Paralysis
• Delayed onset (1-5 weeks) after exposure to organophosphorus esters [4]
• Rare occurrence [3]

Important Considerations:

• The cause of OPIDN is unknown [4]
• OPIDP should be considered in the differential diagnosis of paraparesis [6]
• A thorough medical history and physical examination are crucial for accurate diagnosis [9]

By considering these differential diagnoses, clinical presentation, and important considerations, healthcare professionals can provide accurate diagnosis and treatment for patients with OPIDP.

References:

[1] Not applicable [2] Vasconcellos, LFR (2002) [3] Rao, BRP (2024) [4] Context search result 4 [5] Not applicable [6] Context search result 6 [7] Not applicable [8] Not applicable [9] Coskun, A (2015)