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October 31, 1977

Guillain-Barré Syndrome Following Organophosphate Poisoning

JAMA. 1977;238(18):1950-1951. doi:10.1001/jama.1977.03280190052031

ORGANOPHOSPHORUS compounds are widely used in agriculture as insecticides and defoliants. They are rapidly absorbed through intact skin, as well as from the gastrointestinal and respiratory tracts, to produce a syndrome of acute intoxication.1,2 Rarely, certain organophosphates produce delayed effects on the central and peripheral nervous systems, appearing days to weeks after exposure.2,3 Except for the epidemics of Ginger Jake paralysis,4 resulting from adulteration of alcoholic beverages with triorthocresylphosphate, few cases of organophosphate-induced delayed neurotoxicity have been reported in man. To my knowledge, human intoxication by merphos (Folex), a widely used cotton defoliant, has never been described.

Report of a Case  A healthy 28-year-old man was mixing a cotton defoliant (merphos) when he accidentally splashed a moderate amount of the undiluted chemical on his bare upper arms and T-shirt, soaking the garment through to the skin. He did not wash off the substance or remove the shirt. During