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.