DELAYED NEUROPSYCHIATRIC SYNDROME FOLLOWING CARBON MONOXIDE POISONING: REPORT OF A RARE CASE WITH RESPONSE TO TREATMENT

Yıl 2021, , 16 - 18, 18.03.2021

Özlem Önder , Rıfat Kılıçaslan

https://doi.org/10.33706/jemcr.824095

Öz

Carbon monoxide (CO) is a colorless, odorless, and non-irritant gas that is lighter than air. Carbon monoxide intoxication is the leading factor of deaths due to toxications. Besides, it is an important health problem due to its morbidities related to the delayed neurological and/or psychiatric syndromes that occur after the acute recovery period. Besides behavioral problems, mood and personality changes, parkinsonism, motor deficits, and dementia syndrome are the most common clinical pictures. Compared with hyperbaric oxygen, which has been proven effective in the acute period in CO intoxication, there is no treatment with definitely proven efficacy for the delayed neuropsychiatric picture. In this paper, a case of CO intoxication followed with a delayed neuropsychiatric syndrome is presented in the light of the literature.

Anahtar Kelimeler

carbon monoxide, poisoning, delayed neuropsychiatric syndrome, methylprednisolone, memantine

Kaynakça

• 1. Yurtseven S, Arslan A, Eryigit U, Gunaydin M, Tatli O, Ozsahin F, Karaca Y, Aksut N, Aygun A, Gunduz A. Analysis of patients presenting to the emergency department with carbon monoxide intoxication. Turk J Emerg Med. 2016 Mar 8;15(4):159-62. doi: 10.1016/j.tjem.2015.05.001. PMID: 27239619; PMCID: PMC4882191.
• 2. Chang CC, Chang WN, Lui CC, Wang JJ, Chen CF, Lee YC, Chen SS, Lin YT, Huang CW, Chen C. Longitudinal study of carbon monoxide intoxication by diffusion tensor imaging with neuropsychiatric correlation. J Psychiatry Neurosci. 2010 Mar;35(2):115-25. doi: 10.1503/jpn.090057. PMID: 20184809; PMCID: PMC2834793.
• 3. Weaver LK. Clinical practice. Carbon monoxide poisoning. N Engl J Med. 2009 Mar 19;360(12):1217-25. doi: 10.1056/NEJMcp0808891. PMID: 19297574.
• 4. Hardy KR, Thom SR. Pathophysiology and treatment of carbon monoxide poisoning. J Toxicol Clin Toxicol. 1994;32(6):613-29. doi: 10.3109/15563659409017973. PMID: 7966524.
• 5. Kim JH, Chang KH, Song IC, Kim KH, Kwon BJ, Kim HC, Kim JH, Han MH. Delayed encephalopathy of acute carbon monoxide intoxication: diffusivity of cerebral white matter lesions. AJNR Am J Neuroradiol. 2003 Sep;24(8):1592-7. PMID: 13679276.
• 6. Thom SR, Taber RL, Mendiguren II, Clark JM, Hardy KR, Fisher AB. Delayed neuropsychologic sequelae after carbon monoxide poisoning: prevention by treatment with hyperbaric oxygen. Ann Emerg Med. 1995 Apr;25(4):474-80. doi: 10.1016/s0196-0644(95)70261-x. PMID: 7710151.
• 7. Choi IS. Delayed neurologic sequelae in carbon monoxide intoxication. Arch Neurol. 1983 Jul;40(7):433-5. doi: 10.1001/archneur.1983.04050070063016. PMID: 6860181.
• 8. Shprecher D, Mehta L. The syndrome of delayed post-hypoxic leukoencephalopathy. NeuroRehabilitation. 2010;26(1):65-72. PMID: 20166270; PMCID: PMC2835522.
• 9. Choi IS. Carbon monoxide poisoning: systemic manifestations and complications. J Korean Med Sci. 2001 Jun;16(3):253-61. doi: 10.3346/jkms.2001.16.3.253. PMID: 11410684; PMCID: PMC3054741.
• 10. Lin CH, Su WH, Chen YC, Feng PH, Shen WC, Ong JR, Wu MY, Wong CS. Treatment with normobaric or hyperbaric oxygen and its effect on neuropsychometric dysfunction after carbon monoxide poisoning: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2018 Sep;97(39):e12456. doi: 10.1097/MD.0000000000012456. PMID: 30278526; PMCID: PMC6181555.
• 11. Iwamoto K, Ikeda K, Mizumura S, Tachiki K, Yanagihashi M, Iwasaki Y. Combined treatment of methylprednisolone pulse and memantine hydrochloride prompts recovery from neurological dysfunction and cerebral hypoperfusion in carbon monoxide poisoning: a case report. J Stroke Cerebrovasc Dis. 2014 Mar;23(3):592-5. doi: 10.1016/j.jstrokecerebrovasdis.2013.05.014. Epub 2013 Jun 19. PMID: 23791468.