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Lola Roldán-Tapia,¹ Antonia Leyva,² Francisco Laynez,² and Fernando Sánchez Santed¹

¹Departamento de Neurociencia y Ciencias de la Salud, Universidad de Almería, Almería, Spain; ²Hospital de Poniente, Almería, Spain

Abstract
Here we describe two cases of carbamate poisoning. Patients AMF and PVM were accidentally poisoned by cholinesterase inhibitors. The medical diagnosis in both cases was overcholinergic syndrome, as demonstrated by exposure to cholinesterase inhibitors. The widespread use of cholinesterase inhibitors, especially as pesticides, produces a great number of human poisoning events annually. The main known neurotoxic effect of these substances is cholinesterase inhibition, which causes cholinergic overstimulation. Once AMF and PVM had recovered from acute intoxication, they were subjected to extensive neuropsychological evaluation 3 and 12 months after the poisoning event. These assessments point to a cognitive deficit in attention, memory, perceptual, and motor domains 3 months after intoxication. One year later these sequelae remained, even though the brain magnetic resonance imaging (MRI) and computed tomography (CT) scans were interpreted as being within normal limits. We present these cases as examples of neuropsychological profiles of long-term sequelae related to acute poisoning by cholinesterase inhibitor pesticides and show the usefulness of neuropsychological assessment in detecting central nervous system dysfunction in the absence of biochemical or structural markers. Key words: central nervous system dysfunction, long-term sequelae, neuropsychological profile, pesticide poisoning. Environ Health Perspect 113:762-766 (2005) . doi:10.1289/ehp.7545 available via http://dx.doi.org/ [Online 10 February 2005]

Address correspondence to F. Sánchez Santed, Departamento de Neurociencia y Ciencias de la Salud, Universidad de Almería, La Cañada s/n 04120, Almería, Spain. Telephone: 34-950015159. Fax: 34-950015473. E-mail: fsanchez@ual.es

We thank the Neuropsychological Research Group of the University of La Laguna (Spain) for computed tomography and magnetic resonance imaging management and D. Fuldauer and S.P. Smith for revising the English-language text.

This research was supported by research grants PM 96-0102 (Ministerio de Educación y Ciencia) and PM 99-0146 (Ministerio de Ciencia y Tecnología) .

The authors declare they have no competing financial interests.

Received 3 September 2004 ; accepted 10 February 2005.