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File: 123096_sep96_decls23_0051.txt
Subject: DIAGNOSIS AND TREATMENT OF DISEASES OF IMPORTANCE
Unit: OTSG
Parent Organization: HSC
Box ID: BX003203
Folder Title: DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS
Document Number: 1
Folder Seq #: 88
PARALYSIS IN THE BWICW SETTING
SECTION IV The differential diagnosis must include both botulinum and nerve agent intoxications.
a: Nerve agent is rapid in onset (niinuws to 1-2 hr). A rigid @ysis develop& with
TABLE I parasympathetic excess (salivation, miosis, sweating, involuntary defecation, and urinafion);
DTFFERENTIATION AMONG NERVE AGENT, ATROPINE, central nervous system dysfunction and death soon follow. If exposure is by aerosol or
AND BOTULINUM INTOXICATIONS vapor, constficted pupils, rhinoffhea, and bronch@nstriction also occur.
b: Botutinum toxin is slower in onset (3 hr to several days). Descending paralysis
BOTULINUM TOXIN NERVE AGENT ATROPINE (bulbar to extremities to respiratory) and parasympathetic blockade (dry mouth, pupillary
ating) are characteristic. Paralysis,
agitation, coma, excitation, agitation, nausea, vomiting, and diarrhea may, however, occur after exposure to either nerve agent or
sei@ures irritability, coma botulinum toxin. Central signs (confusion, seizure, coma) @ nine after botulinum, but
common after nerve agent intoxication.
OphthalMOlOgiC Dilated and fixed pupils, Constricted ouoils, dim Weak effects if sual c: Andcholinergics such as atropine can, of course, muse central nervous system
Abnormalities distorted blurred vision, vision (if vapor or aerosol doses given causing changes such as agitation, confusion, and hallucinations u well as dry mouth, dry skin, and
Ptosis, extraocular muscle exposure), linte if any Pupilla@ dilation and
paralysis change it exposed via paralysis of constipation. These changes could easily obscure the correct diagnosis in a soldier who used
skin accommodation his injmtor even without exposure to an agent.
Pa,.Iy Flaccid Paralysis. Early Rigid paralysis ith None of significance
bulbar signs (dvsphonia, t.itching, jerking.
dysphagia) descending to Sei.ures.
upper and lo@e,
extremities. Respiratory
failure.
Autonomic Dry mouth and skin, Excess sali@alion, Dry mouth and skin,
Findings constipation, ileus, rin.@ increased sweating, constipation. ile,s,
retention. Early emesis and involuntary defecation urinary etentio.. E,,Iy
diarrhea aft,, food and Uli.ation. Severe emesis and diarrhea
i@gestio@. 'hi@ovhea and after food ingestion,
bronchoconstriction
occur if exposure is by
inhalation.
Onset 3-36 hours by inhalation 1-10 minutes by Minutes after injection,
exposure. Nei b,,,bed inhalation exposure; 1-2 can be exacerbated by
through intact skin; 1 2-72 hours by dermal dehydration and heat
hours onset by r,l exposure exposure
exposure
9 2
93
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Document 52 f:/Week-36/BX003203/DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS/diagnosis and treatment of diseases of importanc:12179609281524
Control Fields 17
File Room = sep96_declassified
File Cabinet = Week-36
Box ID = BX003203
Unit = OTSG
Parent Organization = HSC
Folder Title = DIAGNOSIS AND TREATMENT OF DISEASES 1991PORTABLE FIELD PERSONNEL SHOWER SYSTEMS
Folder Seq # = 88
Subject = DIAGNOSIS AND TREATMENT OF DISEASES OF IMPORTANC
Document Seq # = 1
Document Date =
Scan Date =
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 17-DEC-1996