P-2-06-21
QUADRIPLEGIA SECONDARY TO ORGANOPHOSPHATE INTOXICATION (CASE REPORT)
Jun M. Park, Kwang S. Kim, Min H. Chun, and Sang B. Ha
(University of Ulsan, College of medicine, Asan Medical Center, Seoul, Korea)
Purpose: 0rganophosphate intoxication causes a delayed polyneuropathy resulting in a quadriplegia. The purpose of this presentation is to share our valuable experience as to a quadriplegia secondary to organophosphate intoxication which is very uncommon in our physiatric practice.
Method: A quadriplegic patient was managed through intensive care unit for life saving care. After the acute medical problems were stabilized. Patient was placed on an extensive rehabilitation therapy.
Result: Patient made a fair recovery of unconciousness, respiratory distress, and ophthalmic problem as well as motor function. Patient was able to walk with bilateral AFO using cane.
Conclusion: Organophosphate intoxication is classified into three categories: acute stage with respiratory and gastrointestinal distress, intermediate, and organophosphate induced delayed polyneuropathy (OPIDP). OPIDP is very rare according to literatures. We report a rare and interesting case with successful rehabilitation. Conservative medical management & extensive rehabilitation therapy enabled patient to reach the functional goal.
P-2-06-22
SEGMENTAL HYPERTROPHY AND PERIPHERAL NEUROPATHY CONCOMITANT WITH NEUROFIBROMATOSIS
Jung. Han-Young (Inha University, Incheon, Korea)
Peripheral neuropathy concomitant with neurofibromatosis is rare. Also added segmental hypertrophy of bone and soft tissue is very rare. We report a case of neurofibromatosis type I who had segmental hypertrophy, neurofibroma and peripheral neuropathy of the one lower limb.
A 13-year-old male child had gait disturbance due to leg length discrepancy and left foot drop. The left leg length was 7cm longer than the right. He was found to be weak with 2/5 strength of left ankle flexor and extensor. He had palpable tender mass along the left sural nerve distribution. Small and large Cafe-au-lait spots were noted on his back and anterior chest.
The electrophysiologic study showed mild conduction block in the left tibial and peroneal nerve. Needle examination of the left tibialis anterior, tibialis posterior, biceps femoris showed no devervation activities, and long, large polyphasic motor unit potentials indicative of a chronic peripheral neuropathy. Computed tomography demonstrated the neurofibroma along the left sciatic, tibial and sural nerve. Biopsy of the sural nerve was compatible with neurofibroma. From above finding, we believed that the patient had neurofibromatosis concomitant with hypertrophy of bone and soft tissue and with peripheral neuropathy of the sciatic nerve of the left lower limb.
