Tongue Fasciculations in Organophosphate Poisoning

Fasciculating toxicity

Organophosphorus (OP) compound poisoning with suicidal intent is common. It is one of the frequent cause for admission to hospital Emergencies and intensive care units in our region. We describe here a case of 19-year old girl who presented to the Emergency Department with atypical features of OP poisoning. She had perioral, tongue and lower limb fasciculations along with generalized muscle weakness with no or minimal muscarinic effects. OP poisoning with isolated nicotinic receptor mediated effect is often reported in children but in adult it is extremely rare. Based on history and clinical suspicion of nicotinic receptor mediated effect of OP, she was given intravenous atropine along with other supportive treatment. Patient got completely recovered from fasciculations and her motor weakness improved after 6 h of atropine therapy. Emergency physician should keep a high index of suspicion of isolated nicotinic and ganglionic mediated effect of OP and a trial of atropine should be given to the patient.

Acute coumaphos organophosphate exposure in the domestic dogs: Its implication on haematology and liver functions

Indiscriminate use of organophosphate acaricides especially among livestock and dog owners in the control of ticks and other ectoparasites has taken a worrisome dimension. In the present study, we investigated, the effects of acute dermal exposure in the form of acaricides baths of coumaphos at different concentrations on the haematology, blood pressure and liver functions in local mongrel dogs.

Twenty-four, male mongrel dogs of about 8 months of age with an average weight of 9.88 ± 0.4 kg were used for the study. The dogs were divided into four groups consisting of six dogs per group. Group A (control) was bathed with ordinary water, while group B was bathed with the recommended concentration of 0.016% (160 ppm) Coumaphos in water. Groups C and D were bathed with 10 and 20 times the recommended dose (1600 ppm and 3200 ppm), respectively.

Significant leucopenia, increased plasma urea and decreased low density lipoprotein (LDL) values were observed at 8 h post exposure, which worsened with time. At 24 and 36 hrs post exposure, normochromic normocytic anaemia, pan leucopenia, bloody diarrhoea, retching, vomiting and paddling were observed in affected animals. Post mortem examination revealed severe lungs, liver and stomach congestion. Multifocal areas of necrosis in the liver and kidney, serosal and mucosal haemorrhages and haemorrhagic meningitis were also observed.

The use of excessively high concentration of organophosphate as acaricides bath is associated with severe anticholinesterase poisoning, which may result in death of affected animals.