•  
  •  
 

Rehabilitation Practice and Science

Translated Title

有機磷中毒所引發的遲發性神經病變：個案報告

Abstract

Organophosphates (OP) are inhibitors of acetylcholinesterase. OP intoxication results in an accumulation of acetylcholine. Clinical signs and symptoms of acute OP poisoning include salivation, incontinence, vomiting, muscle weakness, hypertension, palpitation, restlessness, headache, drowsiness, confusion and seizure. After the acute stage of OP intoxication some patients recover fully, but others have neurologic sequelae, including central and peripheral neuropathy. Individuals with milder cases may recover fully within several months; however, more severe cases may result in persistent sequelae.A 20-year old woman attempted suicide by drinking organophosphate pesticide in 1995. Although emergency and acute medical treatments saved her life, she developed delayed neuropathy, with bilateral weakness in the lower extremities. She was unable to walk and needed a wheelchair for daily transfers. Nerve conduction studies and needle electromyographic examination revealed peripheral neuropathy, with greater involvement of the motor nerves of the lower extremities, and central neuropathy. After an 8-year follow-up, nerve conduction studies showed improvement in amplitude and nerve conduction velocities of the compound muscle action potential, but did not reach normal range. After rehabilitative therapies including: electrical stimulation, range of motion exercise, stretching exercise, muscle strengthening exercise, aquatic exercise, ambulation training with bilateral ankle-foot-orthosis, and activities of daily living (ADL) training, functional improvement was obvious. The patient can now ambulate independently with bilateral axillary crutches. ADL5 are totally independent as well. At this time, the woman we followed has a positive life, with a supportive family, and is gainfully employed.

Language

Traditional Chinese

First Page

235

Last Page

243

Download

Share

COinS