Therapy for acute nerve agent poisoning: An update.

Purpose Of Review: Acute nerve agent poisoning was last reviewed in the neurology literature in 2004. As neurologists may expect to be called upon by non-neurologist colleagues as local experts, it is timely to update the 2004 review.

Recent Findings: Acute antidotal therapy for nerve agent poisoning has been rendered simpler and faster by the FDA approval and introduction of the dual-dose autoinjector.

Case report: Long-term cognitive sequelae of sarin exposure.

The long-term sequelae of acute sarin exposure are not well understood. The largest clinical cohort resulted from the 1994 and 1995 attacks in Japan. Observers noted mostly psychiatric sequelae, with a high prevalence of post-traumatic stress disorder (PTSD).

Neurological problems of famous musicians: the classical genre.

Neurological histories of great musicians allow for a unique perspective on music physiology. Bedrich Smetana's autobiographical string quartet ends with the musical equivalent of tinnitus in the fourth movement, rendering the youthful and passionate themes of earlier movements moot as the piece ends depicting his ultimately fatal disease, neurosyphilis. Dmitri Shostakovich survived the censorship of Joseph Stalin's apparatchiks but suffered a prolonged form of paralysis attributable to slowly progressive motor neuron disease, although the viola sonata he wrote on his deathbed has become standard repertoire.

Liquid sulfur mustard exposure.

A 35-year-old active duty service member sustained a 6.5% body surface area burn as a result of exposure to the chemical warfare agent sulfur mustard, which is the most severe mustard exposure of a U.S.

Vitamin D and Parkinson's disease--a hypothesis.

Parkinson's disease (PD), a common disease of the elderly, is a movement disorder characterized by tremor, akinesia, and loss of postural reflexes, leading to immobility and frequent falls. It results from selective loss (death) of dopaminergic neurons in the substantia nigra region of the brain, largely developed prior to clinical diagnosis, and continuous after diagnosis, despite use of current therapeutic modalities. In PD in the United States the cause and mechanism of continued neuron cell death in the substantia nigra is currently unknown.

Nerve agents.

Background: Nerve agents, the deadliest of the classic chemical warfare agents, primarily function as acetylcholinesterase inhibitors and cause a rapidly progressive cholinergic crisis. Originally developed for battlefield use, they have been used in terrorist attacks and are considered threats to the civilian population.

Review Summary: The pathophysiology and clinical presentation of acute nerve agent poisoning are summarized and acute treatment protocols reviewed.

Sulfur mustard-induced neutropenia: treatment with granulocyte colony-stimulating factor.

Although best known as a blistering agent, sulfur mustard (HD) can also induce neutropenia in exposed individuals, increasing their susceptibility to infection. Granulocyte colony-stimulating factor (G-CSF) and pegylated G-CSF (peg-G-CSF) have been approved by the U.S.

Nerve agents.

Nerve agents cause a rapidly fatal cholinergic crisis, but rapid, appropriate antidotal treatment saves lives. Survivors of nerve-agent poisoning generally are healthy, unlike survivors of some other chemical agent attacks. Neurologists can assist first responders and mass casualty planners materially by serving as resources for information on nerve agents and the syndromes they cause.

Nerve agents: pathophysiology and treatment of poisoning.

Nerve agents, the deadliest of the classical chemical warfare agents, primarily function as acetylcholinesterase inhibitors and cause a rapidly progressive cholinergic crisis. Because of the speed of onset of the syndrome, treatment must be rendered emergently and will most likely be performed by first responders. Neurologists should be familiar with the pathophysiology and treatment of syndromes caused by nerve agents, not only to assist with the hospital care of these patients but also to serve as resources to their local medical communities in preparation for chemical terrorism.

Therapy for nerve agent poisoning.

Neurologists need to familiarize themselves with nerve agents, the most toxic of the chemical warfare agents. Their mode of action lies within the nervous system, and nonneurologists will look to neurologists for expert advice on therapy. These agents cause rapid-onset cholinergic crisis amenable to prompt treatment with specific antidotes.

The birth of nerve agent warfare: lessons from Syed Abbas Foroutan.

The author reviewed Farsi-language articles published recently by Dr. Syed Abbas Foroutan, which constitute the only firsthand clinical descriptions of battlefield nerve agent casualties in the world literature, and the author compares his comments with US and North Atlantic Treaty Organization (NATO) chemical casualty care doctrine. Foroutan's lessons learned reassure us that a robust medical evacuation system, coupled with timely and appropriate medical care of nerve agent poisoning, will save many more lives on future battlefields.

Nerve agent attacks on children: diagnosis and management.

Nerve agents (NAs) are the most lethal chemical weapons. We review the pathophysiology and management of NA poisoning of children. NAs cause cholinergic crisis.