A Clinical Observation of Delayed Neurologic Deterioration Following Carbon Monoxide Poisoning

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Jeon, Beom Seok; Lee, Sang Bok

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Seoul National University College of Medicine
Seoul J Med, Vol.33 No.3, pp. 187-193
Carbon monoxideDelayed neurologic deteriorationParkinsonismPathoclisis
Some patients with anoxic exposure develop new neurologic deficits after
periods of delay when they recover from the initial anoxia. This Delayed Neurologic
Deterioration(DND) is most commonly seen following carbon monoxidelf'O) poisoning.
This study was done to further describe the clinical features of this interesting but rare
entity. We reviewed the records and brain scans of 37 patients who were admitted to
Seoul National University Hospital because of DND following CO poisoning during the
period January 1980 to December 1986. On reviewing the data, we were able to see
certain patterns. Age may be important in the development of DND. Most patients were
in their 40's to 60's. Patients with severe CO poisoning may be at higher risk of
developing DND. However many patients with DND had brief periods of unconsciousness
during acute poisoning. The lucid interval was usually 1-4 weeks. Long lucid interval
may predict good prognosis. Global encephalopathy was the most common.
Post-CO Parkinsonism was diagnosed in 5. Parkinsonism was part of global encephalopathy.
They improved with L-dopa better than with anticholinergics. Low density in
the globus pallidus may not be associated with Parkinsonism. Diffuse brain atrophy
was the most common radiological finding.
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)The Seoul Journal of MedicineThe Seoul Journal of Medicine Vol. 33 No.3 (1992)
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