Apart from the acute presentation, neurological sequelae of organophosphate poisoning may arise. A relapse of the weakness can occur 1 to 4 days after a seemingly welltreated and resolved course. This so-called intermediate syndrome has an incidence of 8% and presents with respiratory paralysis, cranial motor nerve palsies, and proximal limb and neck flexor muscles weakness [109] . Therapy is supportive, but patients may require (re)-intubation. Recurrent weakness typically resolves within 5 to 18 days [109] .