Carbon Monoxide Induced Parkinsonism: A Case Report.

Abstract

A 29 years old patient was reported who developed parkinsonian symptoms after accidental carbon monoxide (CO) poisoning. After exposure to the gas for 15 hours, he was found in a unconscious state and transported to an intensive care unit. His brain CT showed bilateral pallidal hypodensity. Two weeks after CO intoxication, his neurological examination revealed generalized severe akinesia, rigidity, bradymimi, dysphonia and postural instability. He was at a stage 5 of parkinsonizm of Hoehn-Yahr scale and his total score of "Unified Parkinson 's Disease Rating Scale" (UPDRS) was 48. He was given daily 300/75 mg levo-DOPA / benserazide and applied passive exercises. His cranial MRI showed bilateral hypointensity on the globus pallidus and substantia nigra on T2 weighted images compatible with CO intoxication. On the third week, his parkinsonian features were regressed to sage 2 aııd UPDRS scores to 26 which became 14 and 11on the second and fourth months respectively. Actually, he is independent in his daily living activities and the prognosis seems to be good.