Cholinergic crisis

A cholinergic crisis is caused by an oversupply of the neurotransmitter acetylcholine (ACh). It is often caused by drugs such as cholinesterase inhibitors , which are used, for example, to treat myasthenia gravis . Nerve agents or pesticides ( phosphoric acid esters ) or other toxins can also lead to a cholinergic crisis.

Symptoms

A cholinergic crisis manifests itself in acute muscle weakness . In addition, there are symptoms like those that occur with muscarine and nicotine poisoning . The muscarinic symptoms include:

• Gastrointestinal spasms
• diarrhea
• decreased heart rate ( bradycardia )
• increased salivation ( hypersalivation )
• Constriction of the pupil ( miosis )

treatment

The muscarinic symptoms respond well to treatment with atropine . Intubation and ventilation are usually necessary to eliminate the nicotinic side effects .

Differentiation from the myasthenic crisis

A myasthenic crisis can cause similar symptoms (this usually occurs in infections with myasthenia gravis ); the nicotinic ( fasciculations and spasms of the muscles) and muscarinic ( hypersecretion , bradycardia and diarrhea ) effects are typically absent .

Individual evidence

1. ^ DocCheck Medical Services GmbH: Cholinergic crisis. Retrieved June 14, 2019 . 
2. ↑ DS Reddy: A Comparative Toxidrome Analysis of Human Organophosphate and Nerve Agent Poisonings Using Social Media .
3. ↑ ^{a b} Peter Berlit: Clinical Neurology . 2nd Edition. Springer Science & Business Media, 2005, ISBN 978-3-540-01982-4 , pp. 295 .
4. ^ WF Haupt: Intensive medical therapy of the myasthenic crisis. Retrieved June 14, 2019 . 

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !