Organophosphate poisoning versus brainstem stroke

Abstract

Two patients presented unconscious after deliberate organophosphate ingestion. Both were initially misdiagnosed as having brainstem stroke, and plans were made for withdrawing treatment within 24 hours. Once correctly diagnosed and appropriately treated, both recovered, illustrating the importance of considering a wide differential diagnosis before withdrawing support and of not relying on routine "drug screens" to detect organophosphates.