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A terrorist attack on civilian or military populations causing mass casualties is a real threat. The<jats:styled-content style=\"fixed-case\">OP<\/jats:styled-content>nerve agents include soman, sarin, cyclosarin, tabun, and<jats:styled-content style=\"fixed-case\">VX<\/jats:styled-content>. The major mechanism of acute toxicity is the irreversible inhibition of acetylcholinesterase. Acetylcholinesterase inhibition results in the accumulation of excessive acetylcholine levels in synapses, leading to progression of toxic signs including hypersecretions, tremors, status epilepticus, respiratory distress, and death. Miosis and rhinorrhea are the most common clinical findings in those individuals acutely exposed to<jats:styled-content style=\"fixed-case\">OP<\/jats:styled-content>nerve agents. Prolonged seizures are responsible for the neuropathology. The brain region that shows the most severe damage is the amygdala, followed by the piriform cortex, hippocampus, cortex, thalamus, and caudate\/putamen. Current medical countermeasures are only modestly effective in attenuating the seizures and neuropathology. Anticonvulsants such as benzodiazepines decrease seizure activity and improve outcome, but their efficacy depends upon the administration time after exposure to the nerve agent. Administration of benzodiazepines may increase the risk for seizure recurrence. Recent studies document long\u2010term neurologic and behavior deficits, and technological advances demonstrate structural brain changes on magnetic resonance imaging.<\/jats:p>","DOI":"10.1111\/epi.14500","type":"journal-article","created":{"date-parts":[[2018,8,30]],"date-time":"2018-08-30T10:46:40Z","timestamp":1535626000000},"page":"92-99","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":132,"title":["Acute and long\u2010term consequences of exposure to organophosphate nerve agents in humans"],"prefix":"10.1111","volume":"59","author":[{"given":"Taiza H.","family":"Figueiredo","sequence":"first","affiliation":[{"name":"Department of Anatomy, Physiology, and Genetics Uniformed Services University of the Health Sciences Bethesda MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James P.","family":"Apland","sequence":"additional","affiliation":[{"name":"Neuroscience Program US Army Medical Research Institute of Chemical Defense Aberdeen Proving Ground MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria F. 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