Organophosphate-induced delayed neuropathy: A rare case presentation

Abstract

Abstract: Organophosphate-induced delayed neuropathy (OPIDN) is a rare clinical condition. It occurs in association with ingestion of large amount of organophosphorus compound. The clinical picture is characterized by transient paraesthesia, tingling, and numbness usually confined to the distal parts of the limbs, describes as gloves and stockings pattern of sensory impairment, followed by symmetrical motor weakness, which is flaccid type, starts distally in the lower limbs first then ascends to involve upper limbs. The sensory and motor disturbances are usually mild and seen distally, but in more severe cases, it also effects proximal groups of muscles. Electrodiagnostic studies show a motor axonal neuropathy. Our case a 36-year-old female patient, who developed paraesthesia and weakness in all four limbs, 20 days after she had ingested a large amount of 50% chlorpyrifos. The electrophysiological Electromyography (EMG), Nerve conduction study (NCS), Evoked potential (EP) study was characterized by severe motor axonal polyneuropathy effecting both upper and lower limbs, considering the peripheral nerve involvement due to OP poisoning after a delay, so it can be named as OPIDN.