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Delayed neuropsychiatric syndrome in a child following carbon monoxide poisoning.
Brain Dev 2007; 29(3):174-7BD

Abstract

Here, we report the case of a five-year-old boy with carbonic monoxide (CO) poisoning. The patient initially recovered after the initiation of hyperbaric oxygen (HBO) therapy, but lethargy as well as visual and gait disturbances appeared two days later. Left hemiparesis and mood lability also subsequently appeared. Slow frontal activity was noted on electroencephalography, while fluid-attenuation inversion recovery and diffusion-weighted magnetic resonance imaging (MRI) revealed high signal-intensity lesions in the hippocampus and deeper layers of the occipital and frontal cerebral cortex. The neurological symptoms subsided gradually during the 10-day course of HBO therapy, but the left-hand paresis and quadrantic hemianopsia persisted, in association with impaired attention, slow mental processing, and incontinence. Lesions in the globus pallidum were noted on follow-up MRI at 14 days, and cortical lesions became evident as linear, low signal-intensity areas on T1-weighted imaging 4 months after presentation. Delayed neuropsychiatric syndrome in CO poisoning is rare in childhood, although children should be carefully monitored after CO exposure. The finding of cortical laminar necrosis in this patient is quite atypical in CO poisoning, and suggests a broader and previously nonpredicted pathomechanism in this condition.

Authors+Show Affiliations

Divisions of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Japan. holbergs@nifty.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

17008041

Citation

Kondo, Akiko, et al. "Delayed Neuropsychiatric Syndrome in a Child Following Carbon Monoxide Poisoning." Brain & Development, vol. 29, no. 3, 2007, pp. 174-7.
Kondo A, Saito Y, Seki A, et al. Delayed neuropsychiatric syndrome in a child following carbon monoxide poisoning. Brain Dev. 2007;29(3):174-7.
Kondo, A., Saito, Y., Seki, A., Sugiura, C., Maegaki, Y., Nakayama, Y., ... Ohno, K. (2007). Delayed neuropsychiatric syndrome in a child following carbon monoxide poisoning. Brain & Development, 29(3), pp. 174-7.
Kondo A, et al. Delayed Neuropsychiatric Syndrome in a Child Following Carbon Monoxide Poisoning. Brain Dev. 2007;29(3):174-7. PubMed PMID: 17008041.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Delayed neuropsychiatric syndrome in a child following carbon monoxide poisoning. AU - Kondo,Akiko, AU - Saito,Yoshiaki, AU - Seki,Ayumi, AU - Sugiura,Chitose, AU - Maegaki,Yoshihiro, AU - Nakayama,Yusuke, AU - Yagi,Keiichi, AU - Ohno,Kousaku, Y1 - 2006/09/27/ PY - 2006/05/16/received PY - 2006/08/04/revised PY - 2006/08/06/accepted PY - 2006/9/30/pubmed PY - 2007/4/26/medline PY - 2006/9/30/entrez SP - 174 EP - 7 JF - Brain & development JO - Brain Dev. VL - 29 IS - 3 N2 - Here, we report the case of a five-year-old boy with carbonic monoxide (CO) poisoning. The patient initially recovered after the initiation of hyperbaric oxygen (HBO) therapy, but lethargy as well as visual and gait disturbances appeared two days later. Left hemiparesis and mood lability also subsequently appeared. Slow frontal activity was noted on electroencephalography, while fluid-attenuation inversion recovery and diffusion-weighted magnetic resonance imaging (MRI) revealed high signal-intensity lesions in the hippocampus and deeper layers of the occipital and frontal cerebral cortex. The neurological symptoms subsided gradually during the 10-day course of HBO therapy, but the left-hand paresis and quadrantic hemianopsia persisted, in association with impaired attention, slow mental processing, and incontinence. Lesions in the globus pallidum were noted on follow-up MRI at 14 days, and cortical lesions became evident as linear, low signal-intensity areas on T1-weighted imaging 4 months after presentation. Delayed neuropsychiatric syndrome in CO poisoning is rare in childhood, although children should be carefully monitored after CO exposure. The finding of cortical laminar necrosis in this patient is quite atypical in CO poisoning, and suggests a broader and previously nonpredicted pathomechanism in this condition. SN - 0387-7604 UR - https://www.unboundmedicine.com/medline/citation/17008041/Delayed_neuropsychiatric_syndrome_in_a_child_following_carbon_monoxide_poisoning_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0387-7604(06)00176-8 DB - PRIME DP - Unbound Medicine ER -