What is the intermediate syndrome?
According to the cited reference, the intermediate syndrome is a delayed-onset of muscular weakness and paralysis following an episode of acute cholinesterase inhibitor poisoning. It is so named because it can occur between 24-96 hours (1-4 days) after resolution of the acute cholinergic toxidrome and the onset of organophosphate-induced delayed neuropathy (OPIDN) which has been reported to occur 2-3 weeks after resolution of the acute toxidrome.
Karalliedde L, Senanayake N. Organophosphorus insecticide poisoning. Br J Anaesth. 1989 Dec;63(6):736-50. doi: 10.1093/bja/63.6.736. PMID: 2692674
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