Extra-pyramidal parkinsonism complicating organophosphate insecticide poisoning.
Extra-pyramidal parkinsonism complicating organophosphate insecticide poisoning.
复制标题
锥体外系帕金森症并发有机磷杀虫剂中毒。
DOI：
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发表时间：
2001
影响因子：
3.1
通讯作者：
Jameel Andraws
中科院分区：
文献类型：
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作者：
Eli Shahar;Jameel Andraws
我们提出了一个17岁的女性急性锥体外系帕金森综合征并发自杀企图与有机磷杀虫剂毒死蜱，谁最初被怀疑有严重的抑郁症或精神病。入院时，她昏迷不醒，腹泻和大量流涎，呼吸衰竭和昏迷。在接受阿托品和toxogonin治疗沿着机械通气后，她出现了明显的锥体外系帕金森综合征和脑病，其特征为感觉受损和激越，面具脸沿着低沉的声音和吞咽障碍，静止性震颤伴齿轮强直转变为运动迟缓性舞蹈徐动。一旦诊断出帕金森综合征，她就接受了金刚烷胺治疗，完全康复。该患者目前维持金刚烷胺治疗;在计划外停用该药物后，锥体外系体征轻度恶化，9个月后的随访评估显示，她几乎无症状。因此，在任何有机磷中毒患者中，也应该考虑到帕金森病锥体外系综合征，并发有机磷中毒，表现为明显的行为改变，僵硬或运动不能性缄默症，对金刚烷胺有有益的反应。
We present a 1 7-year-old female with acute extra-pyramidal parkinsonism complicating a suicidal attempt with the organophosphate insecticide chlorpyrifos, who was initially suspected to have developed severe depression or psychosis. On admission she was stupurous, with diarrhoea and massive salivation lapsing into respiratory failure and coma. Following atropine and toxogonin treatment along with mechanical ventilation she developed overt extrapyramidal parkinsonism and encephalopathy, characterized by impaired sensorium and agitation, mask facies along with a muffled voice and swallowing impairment, a resting tremor with cogwheel rigidity switching to bradykinetic choreoathetotic movements. Once a parkinsonian syndrome was diagnosed, she was given amantadine therapy with complete recovery. The patient is presently maintained on amantadine therapy; there was mild worsening of her extrapyramidal signs following unplanned discontinuation of this medication, and on follow-up assessments after 9 months she is virtually asymptomatic. A parkinsonian extrapyramidal syndrome, complicating organophosphate intoxication, should therefore also be taken into account in any patient with organophosphate poisoning, presenting with marked behavioural alterations, rigidity or akinetic mutism, and beneficial response to amantadine.