Exposure to organophosphates can lead to “intermediate syndrome.”
It is a syndrome characterized by weakness of neck flexors and proximal limbs, cranial nerve palsies, and respiratory muscle weakness, which can lead to respiratory paralysis.
It follows acute cholinergic syndrome and precedes a delayed neuropathy, thus it is an “intermediate syndrome,” typically developing 24-96 hours post exposure.
The pathophysiology of IMS remains unclear.
Serum cholinesterase levels and electrophysiological studies are helpful in confirming the diagnosis.
With supportive therapy, including artificial ventilation, complete recovery occurs within 5-18 days.
