Unusual presentation of more common disease/injury
Parkinsonism with organophosphate poisoning
1 Department of Neurology, Institute of Clinical Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
2 Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara-shi, Kanagawa, 228-8555, Japan
3 Department of Critical Care Medicine, Institute of Clinical Medicine, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
Correspondence to:
Kiyotaka Nakamagoe, Nakamagoek{at}md.tsukuba.ac.jp
Parkinsonism is a primary neurotoxic manifestation of organophosphate pesticide intoxication. We report here the case of a 67-year-old man who developed acute parkinsonism with tremors and rigidity following exposure to fenitrothion, an organophosphate pesticide. His parkinsonism disappeared, and 2 months later he was able to walk alone without antiparkinsonian drug treatment. To identify particular lesions in the brain, Z score images were obtained from SPECT (single photon emission computed tomography) scans of the patient during the acute poisoning and a follow-up scan performed 2 months later. We indicate that reversible parkinsonism correlated with putaminal hyperperfusion as observed in the Z score images obtained during the acute event; this condition resolved later in concert with resolution of the clinical parkinsonism. We believe that the SPECT scan Z score images in this study are an important find in elucidating parkinsonism manifestations due to organophosphate poisoning.
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Radiology (diagnostics)
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Poisoning
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Neurology
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Drugs: CNS (not psychiatric)
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Movement disorders (other than Parkinsons)
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