Abstract：
OBJECTIVE: This case report aims to describe a rare manifestation of isolated hypoglossal nerve palsy (HNP) resulting from organophosphate poisoning (OP), specifically organophosphate- induced delayed neuropathy (OPIDN). The primary objective of this case report is to highlight this unusual manifestation and discuss its potential underlying mechanisms, emphasizing the importance of timely diagnosis and appropriate management.
METHODS: A 31-year-old male with a history of consuming a commercial chlorpyrifos formulation presented with acute organophosphate poisoning symptoms that improved with appropriate treatment. However, two weeks later, the patient developed neurological deficits (numbness and weakness spreading from the plantar region to the upper limbs) involving the hypoglossal nerve, manifesting as left-sided tongue deviation, fasciculation, and atrophy, resulting in speech and swallowing difficulties. A comprehensive workup ruled out other potential causes of HNP, supporting the link between OPIDN and isolated HNP. Despite regaining limb strength, the patient\'s speech and swallowing issues persisted, prompting a follow-up visit to our hospital for further management and rehabilitation.
CONCLUSIONS: This case report highlights a unique manifestation of OPIDN, resulting in isolated HNP, a rare phenomenon. The correlation between exposure to chlorpyrifos, acute organophosphate poisoning, and delayed onset of HNP suggests a causative relationship. Prompt diagnosis, appropriate treatment, and timely speech and swallowing rehabilitation are vital for optimizing outcomes in such cases. Further research is needed to understand the mechanisms underlying this selective vulnerability of OPIDN and to develop targeted interventions.
METHODS: A 31-year-old male with a history of consuming a commercial chlorpyrifos formulation presented with acute organophosphate poisoning symptoms that improved with appropriate treatment. However, two weeks later, the patient developed neurological deficits (numbness and weakness spreading from the plantar region to the upper limbs) involving the hypoglossal nerve, manifesting as left-sided tongue deviation, fasciculation, and atrophy, resulting in speech and swallowing difficulties. A comprehensive workup ruled out other potential causes of HNP, supporting the link between OPIDN and isolated HNP. Despite regaining limb strength, the patient\'s speech and swallowing issues persisted, prompting a follow-up visit to our hospital for further management and rehabilitation.
CONCLUSIONS: This case report highlights a unique manifestation of OPIDN, resulting in isolated HNP, a rare phenomenon. The correlation between exposure to chlorpyrifos, acute organophosphate poisoning, and delayed onset of HNP suggests a causative relationship. Prompt diagnosis, appropriate treatment, and timely speech and swallowing rehabilitation are vital for optimizing outcomes in such cases. Further research is needed to understand the mechanisms underlying this selective vulnerability of OPIDN and to develop targeted interventions.
摘要：
目的：本病例报告旨在描述由有机磷中毒（OP）引起的孤立性舌下神经麻痹（HNP）的罕见表现，特别是有机磷酸盐引起的迟发性神经病（OPIDN）。本病例报告的主要目的是强调这种不寻常的表现，并讨论其潜在的潜在机制。强调及时诊断和适当管理的重要性。
方法：一名31岁男性，有食用商业毒死蜱制剂的病史，出现急性有机磷中毒症状，经适当治疗后症状得到改善。然而,两周后,患者出现涉及舌下神经的神经功能缺损（麻木和无力从足底区域扩散到上肢），表现为左侧舌头偏离，束感，和萎缩，导致说话和吞咽困难。全面的检查排除了HNP的其他潜在原因，支持OPIDN和孤立的HNP之间的链接。尽管恢复了肢体力量，患者的言语和吞咽问题持续存在，促使我们医院进行后续访问，以进一步管理和康复。
结论：本病例报告突出了OPIDN的独特表现，导致孤立的HNP，一种罕见的现象。毒死蜱暴露之间的相关性，急性有机磷中毒,HNP的延迟发作提示有因果关系。及时诊断,适当的治疗,在这种情况下，及时的言语和吞咽康复对于优化结果至关重要。需要进一步研究以了解OPIDN这种选择性脆弱性的潜在机制，并制定有针对性的干预措施。
方法：一名31岁男性，有食用商业毒死蜱制剂的病史，出现急性有机磷中毒症状，经适当治疗后症状得到改善。然而,两周后,患者出现涉及舌下神经的神经功能缺损（麻木和无力从足底区域扩散到上肢），表现为左侧舌头偏离，束感，和萎缩，导致说话和吞咽困难。全面的检查排除了HNP的其他潜在原因，支持OPIDN和孤立的HNP之间的链接。尽管恢复了肢体力量，患者的言语和吞咽问题持续存在，促使我们医院进行后续访问，以进一步管理和康复。
结论：本病例报告突出了OPIDN的独特表现，导致孤立的HNP，一种罕见的现象。毒死蜱暴露之间的相关性，急性有机磷中毒,HNP的延迟发作提示有因果关系。及时诊断,适当的治疗,在这种情况下，及时的言语和吞咽康复对于优化结果至关重要。需要进一步研究以了解OPIDN这种选择性脆弱性的潜在机制，并制定有针对性的干预措施。
