Pathophysiological studies of neuromuscular function in subacute organophosphate poisoning induced by phosmet.
A 51 year old man developed progressive cranial and proximal muscle weakness, hyperreflexia and mental change. The disorder progressed over 9 days following the fifth weekly spraying with the organophosphate (OP) insecticide, phosmet, with limited symptoms of acute toxicity. Marked decremental responses of 50-80% on slow and fast rates of stimulation were improved to 15% by edrophonium or neostigmine. Intracellular recordings at the endplate region of intercostal muscle revealed small miniature endplate potentials (mepps), reduced mean acetylcholine sensitivity and normal membrane potentials. Electronmicroscopy revealed degeneration and regeneration of the endplates. This study demonstrates that OP poisoning due to phosmet can produce a subacute postsynaptic neuromuscular syndrome without marked symptoms of acute toxicity.
University of Maryland School of Medicine, Department of Neurology, Baltimore 21201.
J L
JL
Good
R K
RK
Khurana
R F
RF
Mayer
W M
WM
Cintra
E X
EX
Albuquerque
D003422:Critical Care; D062787:Drug Overdose / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D004576:Electromyography / Q000187:drug effects; D006801:Humans; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D009045:Motor Endplate / Q000187:drug effects / Q000503:physiopathology / Q000648:ultrastructure; D009132:Muscles / Q000294:innervation; D009460:Neurologic Examination / Q000187:drug effects; D009468:Neuromuscular Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D009469:Neuromuscular Junction / Q000187:drug effects* / Q000503:physiopathology; D010525:Peripheral Nerves / Q000187:drug effects / Q000503:physiopathology; D010706:Phosmet / Q000506:poisoning*; D009435:Synaptic Transmission / Q000187:drug effects* / Q000502:physiology
D010706:Phosmet