Acute organophosphate poisoning presenting with choreo-athetosis

Although it is known that extrapyramidal function is dependent upon a balance between cholinergic and dopaminergic effects, only anti-dopaminergic substances commonly induce extrapyramidal symptoms. This paper describes a patient who ingested chlorpyrifos and presented with choreo-athetosis and depressed cholinesterases. She responded to atropine therapy and made a complete recovery. Although not often described excessive cholinergic activity may also produce extrapyramidal symptoms.