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Neuromuscular Effects of Acute Organophosphate Poisoning

Yıl 2014, Cilt: 39 Sayı: 4, 0 - , 22.07.2014
https://doi.org/10.17826/cutf.02963

Öz

Purpose: The knowledge about neuromuscular effects of organophosphate poisoning depends on limited publications and case reports. In thıs study, we aimed to determine the neuromuscular effects of organophosphate poisoning and the influence of these information in clinical approach and treatment modalities that will guide further studies to prement disability. Materials and Methods: In this prospective study conducted for 2 years with the approval of ethical comittee, 20 patients older than 15 years old who were admitted with cholinergic complaints with suspected organophosphate poisoning were evaluated. After proper primary assesment and treatment Electromyography, Visuel evoked potential, Somatosensory evoked potential were performed to evaluate the neuromuscular affect. Results: Twenty patients, 12 (60%) females and 8 (40%) males were included in our study. Electromyograhy of 20 patients were normal with normal neuromuscular junction functions. Latancy and/or amplitude asymmetry were found in 4 (20%) patients in Visuel evoked potential and 3 (15%) patients in Somatosensory evoked potential. All of the patients were discharged without sequela. Conclusion: There is no evoked potential studies performed in organophosphate poisoning althoung electroneurography repetitive and P300 studies exist in literatüre. More further studies are needed to evaluate the cardiac and neuromuscular effects of organophosphate poisoning.

Kaynakça

  • Karalliedde L, Senanayake N. Organophosphorous poisoning. Br JAnaes.1989;63:736-50.
  • Wyckoff DW, Davies JE, Barquet A, Davis JH. Diagnostic and therapeutic problems of parathion poisoning. Ann Intern Med.1968;68:875-82.
  • Saadeh AM, Farsakh NA, Al-Ali MK. Cardiac manifestations of acute carbamate and organophosphate poisoning. Heart.1997;77:461-4.
  • Kwong TC. Organophosphate pesticides: Biochemistry and clinical toxicology. Ther Drug Monit 2002;24:144-9.
  • Johnson MK, Jacobsen D, Meredith TJ, Eyer P, Heath AJ, Lintenstein AD, Marrs TC; Szinicz L, Vale AJ, Haines JA. Evaluation of antidotes for poisoning by organophosphorus pesticides. Emerg Med.2000;12:22-37
  • Ehrich M, Correll L, Veronesi B. Acetylcholinesterase and neuropathy target esterase inhibitions in neuroblastoma cells to distinguish organophosphorus compounds causing acute and delayed neurotoxicity. Fundam Appl Toxicol.1997;38:55-63
  • Eyer P. Neuropsychopathological changes by organophosphorus compounds-a review. Hum Exp Toxicol.1995;14:857-64
  • Bradley WG, Daroff RB, Fenichel GM, Marsden CD Effect of toxins and physical agents on the nervous system In. Butterworth-Heinemenn. 1991;1185-1209.
  • Lotti, M., Becker, C.E., Aminoff, M.S. Organophosphate polyneuropathy: pathogenesis and prevention. Neurology. 1984;34,658-62.
  • Steenland, K. Chronic neurological effect of organophosphate pesticides. Br. Med. 1996;312:1312-13..
  • Lotti, M. The pathogenesis of organophosphate polyneuropathy. Crit. Rev. Toxicol. 1991;21:465-87.
  • Jokanovic M, Kozanovic M and Stukalov PV. Organophosphate Induced Delayed Polyneuropathy Medicinal Chemistry reviews Online. 2004;1:123-31.
  • De Bleecker JL. The intermediate syndrome in organophosphate poisoning: An overview of experimental and clinical observations. J Toxicol Clin Toxicol.1995;33:683-6.
  • Besser R, Weileman LS, Gutmann L. Efficacy of obidoxime in human organophosphorus poisoning: Determination by neuromuscular transmission studies. Muscle Nerve.1995;18:15-22.
  • Kamel F, Hoppin J. Association of Pesticide Exposure with Neurologic Dysfunction and Disease. Environmental Health Perspectives. 2004;9:950-9.
  • Steenland K, Jenkins B, Ames RG, O'Malley M, Chrislip D, Russo J. Chronic Neurological Sequelae to Organophosphate Pesticide Poisoning. Am J Public Health. 1994;84:731-7.
  • Slotkin TA, Oliver CA, Seidler FJ. Critical periods for the role of oxidative stress in the developmental neurotoxicity of chlorpyrifos and terbutaline, alone or in combination. Dev Brain Res. 2005;157:172-80.
  • Wesseling C, Keifer M, Ahlbom A, Mcconnell R, Moon Jd, Rosenstock L, et al. Long-term neurobehavioral effects of mild poisonings with Organophosphate and n-Methyl Carbamate pesticides among banana workers. Int J Occup Environ Health. 2002;8:27–34.
  • Huang X, Hites RA, Foran JA, Hamilton C, Knuth BA, Schwager JA, et al. Consumption advisories for salmon based on risk of cancer and noncancer health effects. Environ Res. 2006:101;263-74.
  • Handal AJ, Lozoff B, Breilh J, Harlow SD. Effect of Community of residence on neurobehavioral development in ınfants and young children in a flower-growing region of Ecuador. Environ Health Perspect. 2007;115:128–33.
  • Lotti M, Moretto A. Poisoning by organophosphorus insecticides and sensory neuropathy. J Neurol Neurosurg Psychiatry. 1998;64:463-8.
  • Koc F, Kekec Z, Yerdelen D. Nerve conduction studies and motor end-plate function in patients with organophosphorus intoxication. 13th European Congress of Clinical Neurophysiology / Clinical Neurophysiology. 2008;119:1–131.
  • Yazışma Adresi / Address for Correspondence: Dr.Taylan Peköz Adana Numune Eğitim ve Araştırma Hastanesi Acil Tıp Anabilim Dalı ADANA E-mail: taylanpekoz@gmail.com geliş tarihi/received :14.04.2014 kabul tarihi/accepted:30.04.2014

Akut Organofosfat Zehirlenmelerinde Nöromusküler Etkilenim

Yıl 2014, Cilt: 39 Sayı: 4, 0 - , 22.07.2014
https://doi.org/10.17826/cutf.02963

Öz

Amaç: Organofosfat zehirlenmelerinin nöromusküler etkileri ile ilgili bilgiler sınırlı yayın ve olgu sunumlarına dayanmaktadır. Bu çalışmada akut organofosfat zehirlenmelerinde organofosfatın nöromuskuler etkilenimini araştırmayı ve bunun acil yaklaşım ve tedaviye katkısını belirleyerek organofosfat zehirlenmesine bağlı gelişen olası sakatlıkların azaltılması amacıyla sonraki yapılacak çalışmalara yol gösterici olmayı hedefledik. Materyal ve Metod: İleriye dönük olarak yapılan bu çalışmada 2 yıl boyunca Organofosfat zehirlenmesini düşündüren kolinerjik zehirlenme bulgularıyla Acil Servise başvuran 15 yaş üstü 20 hasta değerlendirildi. Uygun ilk değerlendirme ve tedavi sonrası hastaların nöromuskuler etkilenimi değerlendirmek için Elektromyogarfi, Görsel uyarılmış potansiyel, Somatosensöriyel uyarılmış potansiyel incelemeleri yapıldı. Bulgular: Çalışmamıza 12"si (%60) kadın, 8"i (%40) erkek toplam 20 hasta alındı. Yirmi hastaya yapılan Elektromyografi incelemesinde sinir ileti çalışmaları normal bulundu. Olgular hepsinde motor son plak işlevleri normal olarak değerlendirildi. Dört (%20,0) hastada görsel uyarılmış potansiyel, 3 (%15,0) hastada somatosensöriyel uyarılmış potansiyel incelemelerinde latans ve/veya amplitüd asimetrisi saptandı. Hastalar tam iyilik haliyle taburcu edildi. Sonuç:.Organofosfat zehirlenmesinde elektronörografi, repetetif çalışma ve P300 çalışmaları olmasına rağmen uyarılmış potansiyel çalışmalarına rastlanmamıştır.Organofosfat zehirlenmesinde kardiyak ve nöromuskuler etkilenimi göstermek için daha geniş çalışmalara ihtiyaç vardır.

Kaynakça

  • Karalliedde L, Senanayake N. Organophosphorous poisoning. Br JAnaes.1989;63:736-50.
  • Wyckoff DW, Davies JE, Barquet A, Davis JH. Diagnostic and therapeutic problems of parathion poisoning. Ann Intern Med.1968;68:875-82.
  • Saadeh AM, Farsakh NA, Al-Ali MK. Cardiac manifestations of acute carbamate and organophosphate poisoning. Heart.1997;77:461-4.
  • Kwong TC. Organophosphate pesticides: Biochemistry and clinical toxicology. Ther Drug Monit 2002;24:144-9.
  • Johnson MK, Jacobsen D, Meredith TJ, Eyer P, Heath AJ, Lintenstein AD, Marrs TC; Szinicz L, Vale AJ, Haines JA. Evaluation of antidotes for poisoning by organophosphorus pesticides. Emerg Med.2000;12:22-37
  • Ehrich M, Correll L, Veronesi B. Acetylcholinesterase and neuropathy target esterase inhibitions in neuroblastoma cells to distinguish organophosphorus compounds causing acute and delayed neurotoxicity. Fundam Appl Toxicol.1997;38:55-63
  • Eyer P. Neuropsychopathological changes by organophosphorus compounds-a review. Hum Exp Toxicol.1995;14:857-64
  • Bradley WG, Daroff RB, Fenichel GM, Marsden CD Effect of toxins and physical agents on the nervous system In. Butterworth-Heinemenn. 1991;1185-1209.
  • Lotti, M., Becker, C.E., Aminoff, M.S. Organophosphate polyneuropathy: pathogenesis and prevention. Neurology. 1984;34,658-62.
  • Steenland, K. Chronic neurological effect of organophosphate pesticides. Br. Med. 1996;312:1312-13..
  • Lotti, M. The pathogenesis of organophosphate polyneuropathy. Crit. Rev. Toxicol. 1991;21:465-87.
  • Jokanovic M, Kozanovic M and Stukalov PV. Organophosphate Induced Delayed Polyneuropathy Medicinal Chemistry reviews Online. 2004;1:123-31.
  • De Bleecker JL. The intermediate syndrome in organophosphate poisoning: An overview of experimental and clinical observations. J Toxicol Clin Toxicol.1995;33:683-6.
  • Besser R, Weileman LS, Gutmann L. Efficacy of obidoxime in human organophosphorus poisoning: Determination by neuromuscular transmission studies. Muscle Nerve.1995;18:15-22.
  • Kamel F, Hoppin J. Association of Pesticide Exposure with Neurologic Dysfunction and Disease. Environmental Health Perspectives. 2004;9:950-9.
  • Steenland K, Jenkins B, Ames RG, O'Malley M, Chrislip D, Russo J. Chronic Neurological Sequelae to Organophosphate Pesticide Poisoning. Am J Public Health. 1994;84:731-7.
  • Slotkin TA, Oliver CA, Seidler FJ. Critical periods for the role of oxidative stress in the developmental neurotoxicity of chlorpyrifos and terbutaline, alone or in combination. Dev Brain Res. 2005;157:172-80.
  • Wesseling C, Keifer M, Ahlbom A, Mcconnell R, Moon Jd, Rosenstock L, et al. Long-term neurobehavioral effects of mild poisonings with Organophosphate and n-Methyl Carbamate pesticides among banana workers. Int J Occup Environ Health. 2002;8:27–34.
  • Huang X, Hites RA, Foran JA, Hamilton C, Knuth BA, Schwager JA, et al. Consumption advisories for salmon based on risk of cancer and noncancer health effects. Environ Res. 2006:101;263-74.
  • Handal AJ, Lozoff B, Breilh J, Harlow SD. Effect of Community of residence on neurobehavioral development in ınfants and young children in a flower-growing region of Ecuador. Environ Health Perspect. 2007;115:128–33.
  • Lotti M, Moretto A. Poisoning by organophosphorus insecticides and sensory neuropathy. J Neurol Neurosurg Psychiatry. 1998;64:463-8.
  • Koc F, Kekec Z, Yerdelen D. Nerve conduction studies and motor end-plate function in patients with organophosphorus intoxication. 13th European Congress of Clinical Neurophysiology / Clinical Neurophysiology. 2008;119:1–131.
  • Yazışma Adresi / Address for Correspondence: Dr.Taylan Peköz Adana Numune Eğitim ve Araştırma Hastanesi Acil Tıp Anabilim Dalı ADANA E-mail: taylanpekoz@gmail.com geliş tarihi/received :14.04.2014 kabul tarihi/accepted:30.04.2014
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Araştırma
Yazarlar

Taylan Peköz Bu kişi benim

Mehmet Yüzügüllü Bu kişi benim

Zeynep Kekeç Bu kişi benim

Filiz Koç

Yayımlanma Tarihi 22 Temmuz 2014
Yayımlandığı Sayı Yıl 2014 Cilt: 39 Sayı: 4

Kaynak Göster

MLA Peköz, Taylan vd. “Akut Organofosfat Zehirlenmelerinde Nöromusküler Etkilenim”. Cukurova Medical Journal, c. 39, sy. 4, 2014, doi:10.17826/cutf.02963.