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BMJ Case Reports 2009; doi:10.1136/bcr.04.2009.1766
  • Unusual presentation of more common disease/injury

Parkinsonism with organophosphate poisoning

  1. Kiyotaka Nakamagoe1,
  2. Masahiko Watanabe1,
  3. Tohoru Takeda2,
  4. Taro Mizutani3,
  5. Akira Tamaoka1
  1. 1
    Department of Neurology, Institute of Clinical Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
  2. 2
    Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara-shi, Kanagawa, 228-8555, Japan
  3. 3
    Department of Critical Care Medicine, Institute of Clinical Medicine, Tennodai 1-1-1, Tsukuba, Ibaraki, 305-8575, Japan
  1. Kiyotaka Nakamagoe, Nakamagoek{at}md.tsukuba.ac.jp
  • Published 13 August 2009

Summary

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.

Footnotes

  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication

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