Chronic Organophosphate Pesticide Poisoning: Optic-Autonomic Neuropathy


Satoshi Ishikawa, Mikio Miyata & Yoshiro Taneda
Department of Ophthalmology, School of Medicine, Kitasato University, Sagamihara, Japan

Chronic exposure to organophosphorus pesticides (OP) produces delayed-neurotoxic involvements. We have experienced 20 cases of the patients with chronic OP intoxication during past 9 years at our hospital. All cases had an extensive contact with OP. Their initial symptoms were reduced vision (50%), disturbance of autonomic nervous system (25%), and numbness and gait difficulty (25%) etc. They had the following clinical manifestations; visual fields’ narrowings, abnormal accommodation, vertical gaze palsy, sensorial or motor neuropathy of the legs, EEG abnormality with abnormal REM sleep, and disturbance of the body balance. Blood analysis including cholinesterases and pesticide will be evaluated.

Treatment was made by prolonged use of atropine nitrate or pralidoximes, if necessary. Some signs improved and some not by the treatment.

Clinically, chronic OP intoxication will be summarized as optic-autonomic peripheral neuropathy. Until the patients visited us, all cases were left along without diagnosis. We would like to emphasize the significance of detailed neurological and ophthalmological examinations for these patients.