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- 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.