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Supranuclear gaze palsy and opsoclonus after Diazinon poisoning

¹ Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
² Department of Ophthalmology, University of Pennsylvania School of Medicine

Correspondence to:
Correspondence to:
Dr Tsao-Wei Liang, Department of Neurology, 3 East Gates, 3400 Spruce Street, Philadelphia, PA 19104, USA;
liangtw{at}msn.com

ABSTRACT
A 52 year old man developed a supranuclear gaze palsy and opsoclonus after Diazinon poisoning. The diagnosis was confirmed by low plasma and red blood cell cholinesterase activity and urine mass spectroscopy. Saccadic control may be mediated in part by acetylcholine. Opsoclonus in the setting of organophosphate intoxication may occur as a result of cholinergic excess which overactivates the fastigial nuclei.

Keywords: Diazinon; opsoclonus; organophosphates; supranuclear palsy