The effectiveness of various carbamate-oxime combinations was evaluated against GD-induced pathophysiology in guinea pigs chronically instrumented for the monitoring of EEG, diaphragm EMG, and ECG. Animals were pretreated with either a tertiary (physostigmine, PHY; 0.015 mg/kg, im) or a quaternary (pyridostigmine, PYR; 0.026 mg/kg, im) carbamate 30 min prior to GD intoxication (2xLD50; 52 μg/kg, sc). Seconds after GD, the animals were given i) 2-PAM (25 mg/kg, im), ii) HI-6 (125 mg/kg, ip), or iii) MMB4 (26.1 mg/kg, im) and an im mixture of methylatropine (2 mg/kg) and scopolamine. HBr (0.1 mg/kg). Group 1 (PHY/MMB4) and 2 (PYR/MMB4) animals displayed mild degrees of dystonia/tremor but were asymptomatic 24 hr post-GD. Groups 3 (PHY/HI-6) and 4 (PYR/HI-6) showed more severe neurobehavioral anomalies (prolonged atonia, tremor, and incapacitation). Group 3 animals all survived 24 hr later. In Group 4, 50% of the animals seized and 17% died. Group 5 (PHY/2-PAM) and 6 (PYR/2-PAM) animals all showed extended periods of incapacitation, severe neurobehavioral deficits, and seizures. Lethality was noted in 17% of Group 6 animals. In summary, preservation of AChE with a centrally active carbamate (PHY) pretreatment and MMB4 therapy appeared to offer the greatest degree of protection against lethality and development of seizures and neurobehavioral abnormalities.