Taylan PEKÖZ, Mehmet YÜZÜGÜLLÜ, Zeynep KEKEÇ, Filiz KOÇ

Akut Organofosfat Zehirlenmelerinde Nöromusküler Etkilenim

Amaç: Organofosfat zehirlenmelerinin nöromusküler etkileri ile ilgili bilgiler sınırlı yayın ve olgu sunumlarına dayanmaktadır. Bu çalışmada akut organofosfat zehirlenmelerinde organofosfatın nöromuskuler etkilenimini araştırmayı ve bunun acil yaklaşım ve tedaviye katkısını belirleyerek organofosfat zehirlenmesine bağlı gelişen olası sakatlıkların azaltılması amacıyla sonraki yapılacak çalışmalara yol gösterici olmayı hedefledik. Materyal ve Metod: İleriye dönük olarak yapılan bu çalışmada 2 yıl boyunca Organofosfat zehirlenmesini düşündüren kolinerjik zehirlenme bulgularıyla Acil Servise başvuran 15 yaş üstü 20 hasta değerlendirildi. Uygun ilk değerlendirme ve tedavi sonrası hastaların nöromuskuler etkilenimi değerlendirmek için Elektromyogarfi, Görsel uyarılmış potansiyel, Somatosensöriyel uyarılmış potansiyel incelemeleri yapıldı. Bulgular: Çalışmamıza 12"si (%60) kadın, 8"i (%40) erkek toplam 20 hasta alındı. Yirmi hastaya yapılan Elektromyografi incelemesinde sinir ileti çalışmaları normal bulundu. Olgular hepsinde motor son plak işlevleri normal olarak değerlendirildi. Dört (%20,0) hastada görsel uyarılmış potansiyel, 3 (%15,0) hastada somatosensöriyel uyarılmış potansiyel incelemelerinde latans ve/veya amplitüd asimetrisi saptandı. Hastalar tam iyilik haliyle taburcu edildi. Sonuç:.Organofosfat zehirlenmesinde elektronörografi, repetetif çalışma ve P300 çalışmaları olmasına rağmen uyarılmış potansiyel çalışmalarına rastlanmamıştır.Organofosfat zehirlenmesinde kardiyak ve nöromuskuler etkilenimi göstermek için daha geniş çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

Elektromyografi, Organofosfat zehirlenmesi, Nöromusküler komplikasyonlar,

Neuromuscular Effects of Acute Organophosphate Poisoning

Purpose: The knowledge about neuromuscular effects of organophosphate poisoning depends on limited publications and case reports. In thıs study, we aimed to determine the neuromuscular effects of organophosphate poisoning and the influence of these information in clinical approach and treatment modalities that will guide further studies to prement disability. Materials and Methods: In this prospective study conducted for 2 years with the approval of ethical comittee, 20 patients older than 15 years old who were admitted with cholinergic complaints with suspected organophosphate poisoning were evaluated. After proper primary assesment and treatment Electromyography, Visuel evoked potential, Somatosensory evoked potential were performed to evaluate the neuromuscular affect. Results: Twenty patients, 12 (60%) females and 8 (40%) males were included in our study. Electromyograhy of 20 patients were normal with normal neuromuscular junction functions. Latancy and/or amplitude asymmetry were found in 4 (20%) patients in Visuel evoked potential and 3 (15%) patients in Somatosensory evoked potential. All of the patients were discharged without sequela. Conclusion: There is no evoked potential studies performed in organophosphate poisoning althoung electroneurography repetitive and P300 studies exist in literatüre. More further studies are needed to evaluate the cardiac and neuromuscular effects of organophosphate poisoning.

Keywords:

Electromyography , organophosphate poisoning, neuromuscular effects,

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Yazışma Adresi / Address for Correspondence: Dr.Taylan Peköz Adana Numune Eğitim ve Araştırma Hastanesi Acil Tıp Anabilim Dalı ADANA E-mail: taylanpekoz@gmail.com geliş tarihi/received :14.04.2014 kabul tarihi/accepted:30.04.2014