ACHE and polyneuropathy: Functionally, malathion impairs the ability of the synaptic enzyme acetylcholinesterase (AChE) to break down the neurotransmitter acetylcholine (ACh) within the synaptic clefts of neuromuscular junctions and can lead to detrimental outcomes such as respiratory distress, coma, muscle pain, distal numbness, delayed polyneuropathy, and death (van Helden and Bueters 1999; Krstic et al. 2008).