Delayed Encephalopathy of Carbon Monoxide Intoxication and Treatment with Hyperbaric Oxygen:  A Case Report

Fatma Polat; Nur Yüceyar; Ali Akay; Ayşe Sağduyu Kocaman

doi:10.4274/Tnd.92259

Fatma Polat¹, Nur Yüceyar¹, Ali Akay², Ayşe Sağduyu Kocaman¹

¹Ege University Medical Faculty Deparment Of Neurology, İzmir/ Türkiye
²Ege University Medical Faculty Deparment Of Neurosurgery, İzmir/ Türkiye

Keywords: carbon monoxide (CO), intoxication, delayed encephalopaty, magnetic resonance imaging(MRI), hyberbaric oxgen therapy

Abstract

Delayed encephalopathy (DE) is a neuropsychiatric syndrome that can arise generally within 20 days of acute carbon monoxide (CO) intoxication after apparent recovery and involves variable degrees of cognitive deficits, personality changes, movement disorders and focal neurologic deficits. We report a 35-year-old female patient with delayed encephalopathy due to CO intoxication, presenting with cognitive impairment and mild parkinsonism despite receiving hyberbaric oxigen therapy (HBO). Magnetic resonance imaging showed abnormal signal intensity and decreased diffusivity at both caudate nuclei and globus pallidus. She continued to receive additional HBO therapy and complete recovery was reached within six months. The positive effect of early HBO therapy of selected patients in reversing the acute effects of CO intoxication is appearant. We here also review the beneficial effect of HBO in preventing or limitating the late neurocognitive deficits associated with severe CO intoxication.