Intermediate Syndrome: Cranial Nerve & Brain Stem Lesions
The intermediate syndrome is a specific neurological complication following organophosphate poisoning.
Defining Intermediate Syndrome
This syndrome typically emerges 24 to 96 hours after exposure, after the initial acute cholinergic symptoms have subsided.
It is characterized by:
- Dysfunction of cranial nerves.
- Lesions affecting the brain stem.
- Weakness in proximal muscles and respiratory muscles.
Comparing Syndromes
Understanding the timing and symptoms helps differentiate:
- Acute Cholinergic Syndrome: Immediate onset, severe hyper-secretion, muscarinic and nicotinic symptoms.
- Organophosphate-Induced Delayed Neuropathy (OPIDN): Occurs 1-3 weeks later, primarily causing peripheral nerve damage (especially in legs).
- Intermediate Syndrome: Occurs days after exposure, targeting cranial nerves and brain stem, distinguishing it from both acute and delayed effects.
Correct Identification
The clinical presentation of cranial nerve and brain stem lesions is the defining feature of the intermediate syndrome in organophosphate poisoning.
Important Questions from Chemical Poisoning
Consider the following statements regarding organophosphate-induced delayed polyneuropathy (OPIDN) :
1. It is a rare complication and occurs 2 - 3 weeks after acute exposure.
2. It is a feature of poisoning with certain organophosphorus compounds such as triorthocresyl phosphate.
3. Inhibition of acetylcholinesterase causes motor polyneuropathy with no evidence of sensory loss.
4. There is no specific therapy although regular physiotherapy may limit deformity caused by muscle wasting.
Which of the statements given above are correct?
- The toxic effects of aluminium phosphide is due to the release of:
- Use of calcium carbide for the artificial ripening of fruits is banned but it is often reported to be illegally used. What is/are the likely health hazards of exposure to this chemical?
1. Permanent damage to the eyes
2. Pulmonary edema
3. Irritation of mouth, throat and nose
Select the correct answer using the codes given below: - Which of the following statements is correct regarding Malachite that is used as food adulterant?
Which of the following parts of the human body can be used as a sample/samples for the presence of mercury?
1. Blood
2. Hair
3. Nail
Select the correct answer using the code given below:
