Wallerian degeneration in the brain after organophosphorus poisoning: a case report

• Published in: Annals of medicine and surgery 2023-04, Vol.85 (4), p.926-930
• Main Authors: Gajurel, Bikram P, Giri, Subarna, Poudel, Navin, Kharel, Sanjeev, Karn, Ragesh, Rajbhandari, Reema, Ojha, Rajeev, Gautam, Niraj, Shrestha, Aashish
• Format: Article
• Language: English
• Subjects: Case Reports
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1097/MS9.0000000000000102

The type, quantity, and potency of the organophosphorus compound (OPC) taken determine the symptoms of OPC poisoning as well as their severity. The exact etiology for organophosphorus (OP) poisoning delay neuropathy regulating Wallerian degeneration is still unknown. We report here a rare case of a 25-year-old lady with Wallerian degeneration in the brain found in an MRI in a patient after OPC ingestion. MRI of the brain, in our case, shows Wallerian degeneration of the corona radiata, internal capsule, and midbrain. Some OPCs can lead to OP-induced delayed neuropathy, a form of delayed neurotoxicity in humans (OPIDN). The distal axonopathy's (in OPIDN) morphological pattern resembles Wallerian degeneration, which happens following nerve damage. Although delayed Wallerian degeneration from organophosphate poisoning often affects the peripheral nervous system, it can also affect the central nervous system. Rehabilitation therapy combined with appropriate nursing care has been demonstrated to improve the disease. Central nervous system involvement after OP poisoning is rare, and MRI of the brain and spinal cord can document evidence of Wallerian degeneration after OP poisoning.