Treatment of acute organophosphate poisoning: evidence of a direct effect on central nervous system by 2-PAM (pyridine-2-aldoxime methyl chloride).

Management of acute organophosphate poisoning in man includes rapid treatment with atropine and oximes. Oximes are thought to be unable to enter the central nervous system. We describe a case of parathion poisoning in a 3-1/2 year-old child and the effect of treatment with oxime 2-PAM (34 mg/kg) on EEG activity and clinical symptoms. The prompt improvement of cortical electrical activity documented by EEG could not be explained by any improvement of circulatory or respiratory function and has to be considered a direct effect of oximes on the central nervous system.