The clinical and electrophysiological features of a delayed polyneuropathy developing subsequently after acute organophosphate poisoning and it's correlation with the serum acetylcholinesterase

Abstract

Introduction: Organophosphorus-induced delayed polyneuropathy (OPIDP) characterised with cramping pain, paresthesias in the lower extremities and occasionally in the hands, followed by weakness of the distal limb muscles, especially in the legs, and partial denervation of affected muscles often develops within first 3 weeks following acute poisoning.

Objectives: To determine the incidence of development of subsequent polyneuropathy among patients with acute organophosphate poisoning (OPP), to assess whether there was a difference between patient groups with severe poisoning and mild poisoning for the development of polyneuropathy, to determine whether there was a correlation between the serum AChE levels and the development of OPIDP, and to define the clinical and electrophysiological features of OPIDP.

Methods: Forty-one patients with acute OPP admitted to the Emergency department were included in this retrospective study. On days 1, 2, 3, and 7, each patient was assessed clinically, with the measurement of serum AChE, and results were recorded on special forms.

Results: OPIDP was diagnosed clinically in 14 patients (34.15%) during the 14th to 22nd days after poisoning. Twelve (85.7%) of 14 patients had a severe clinical status on day 1 after poisoning. The frequency of development of OPIDP was higher in the patients with severe poisoning than the patients with mild poisoning (p = 0.041). There was no significant correlation between the serum AChE levels and the development of OPIDP.

Conclusion: We conclude that the serum AChE levels measured on the first day and consecutive several days can not be the predictive of the development of subsequent OPIDP.