pralidoxime and Hoarseness

Ten patients with intermediate syndrome (IMS) after acute organophosphorus (OP) pesticides poisoning were observed. The occurrence rate of IMS was 5.4% among total inpatients of acute OP poisoning in the same period. The majority of IMS cases were of severe oral OP poisoning. Seven to 68 hours after poisoning there were initial signs including motor weakness of muscles innervated by the 9th and 10th cranial nerves (e.g. dysphagia, hoarse voice). The neck flexor muscles and proximal limb muscles were also involved. Patients with respiratory muscle paralysis usually required urgent tracheal intubation and mechanical ventilation. The IMS in this group persisted for 6-30 days (mean 13 days) with no fatality. The relevant kinds of pesticide, the development and regression of IMS, and the treatment and possible mechanism of IMS were discussed.

Topics: Adult; Antidotes; Atropine; Cholinesterase Reactivators; Deglutition Disorders; Female; Hoarseness; Humans; Insecticides; Male; Middle Aged; Organophosphorus Compounds; Pralidoxime Compounds; Respiration, Artificial; Respiratory Paralysis; Syndrome