As a result of cholinergic crisis, the muscles stop responding to the high synaptic levels of acetylcholine, leading to flaccid paralysis, respiratory failure, and other signs and symptoms reminiscent of organophosphate poisoning.
Other symptoms include increased sweating, salivation, bronchial secretions along with miosis (constricted pupils).
[citation needed] This crisis may be masked by the concomitant use of atropine along with cholinesterase inhibitor medication in order to prevent side effects.
Flaccid paralysis resulting from cholinergic crisis can be distinguished from myasthenia gravis by the use of the drug edrophonium (Tensilon), as it only worsens the paralysis caused by cholinergic crisis but strengthens the muscle response in the case of myasthenia gravis.
[citation needed] Some of the symptoms of increased cholinergic stimulation include: Cholinergic crisis, sometimes known by the mnemonic "SLUDGE syndrome" (salivation, lacrimation, urination, defecation, gastrointestinal distress, and emesis),[4] can be a consequence of: Some elements of the cholinergic crisis can be reversed with antimuscarinic drugs like atropine or diphenhydramine, but the most dangerous effect — respiratory depression, cannot.