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July 1979

Triorthocresyl Phosphate Neuropathy

Author Affiliations

Institute of Neurology and Psychiatry Berceni 10, C.P.5880 R-75622 Bucharest, Romania

Arch Neurol. 1979;36(7):455. doi:10.1001/archneur.1979.00500430085025

To the Editor.—  I read with interest the article entitled "Jamaica Ginger Paralysis" published in the August Archives (35:530-532, 1978). In this article, the authors show especially the delayed neurotoxic effects of triorthocresyl phosphate (TOCP). Our clinical and electrophysiological examinations,1.2 performed on 12 patients two to three months after poisoning with TOCP and, on two of them, also up to 13 years later, suggested the existence of two clinicoelectrophysiological forms of neuropathy: (1) The predominantly spinal form is characterized by a clinical picture resembling that in amyotrophic lateral sclerosis, a long course and persistence of residual signs of neuropathy for several years after ingestion of the toxic substance. The electrophysiological data point to an underlying neuronal and axonal degeneration. A pure spinal motor form was found in two cases of intoxication with the organophosphorus insecticides trichlorfon (Dipterex) and divipan. A neuronal degeneration would underlie the neuropathy in these two