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Case Reports
. 2007 May;11(2):80-2.
doi: 10.4103/0019-5278.34534.

Reversible delayed neuropsychiatric syndrome following acute carbon monoxide exposure

R Bhatia  1 , F Chacko, V Lal, B R Mittal
Affiliations
Case Reports

Reversible delayed neuropsychiatric syndrome following acute carbon monoxide exposure

R Bhatia et al. Indian J Occup Environ Med. 2007 May.

Abstract

A 40-year-old male presented with acutely oncoming neuropsychiatric symptoms in the form of extrapyramidal disturbances, personality change, behavior changes and urinary incontinence. One month prior to this symptomatology, he had been found unconscious in his closed room where a coal fire was burning overnight. He recovered completely in two days with supportive therapy. Magnetic resonance imaging during this presentation showed bilateral white matter changes suggestive of demyelination. Tc99m-ECD SPECT study revealed hypoperfusion in bilateral frontal region. He was managed conservatively and eventually made a nearly complete recovery. Repeat SPECT study revealed marked improvement in tracer uptake correlating with his improvement. Delayed neuropsychiatric syndrome after acute carbonmonoxide poisoning is a rare and distinct entity. This case report discusses the various aspects of this disease entity.

Keywords: Carbonmonoxide poisoning; demyelination.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Cranial MRI axial T2W images showing multiple white matter hyper intensities (arrows) in (a) bilateral frontal and pareitooccipital regions and (b) centrumsemiovale
Figure 2
Figure 2
Tc99m-ECD SPECT. Initial presentation (a, b) shows reduced tracer uptake in bifrontal regions (arrows; less dark region indicates poor perfusion). At 4 months follow-up (c, d), shows marked improvement in perfusion (dark areas indicates normal perfusion)
See this image and copyright information in PMC

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