Isolated unilateral brachial plexus injury following carbon monoxide intoxication: a case report

Abstract

Background CO is an odorless, colorless gas that often still undetectable until exposure results in coma or death. Carbon monoxide (CO) intoxication is a common fatal poisoning worldwide. The toxic effects of CO lead to tissue hypoxia and produce systemic and neurological complications. Besides, some severe neurological manifestations and delayed sequelae may occur after CO intoxication. However, peripheral neuropathy following CO poisoning is relatively rare that usually occurs in young people. Beforehand, only one case reported unilateralplexopathy following CO poisoning, which combined with rhabdomyolysis and cognitive dysfunction. Case presentation A 31-year-old young man slept in his private car with closed doors and windows. His wife discovered him in about 7 hours when he was in an unconscious state. He was diagnosed with acute carbon monoxide poisoning. After about 12 hours in a coma, he returned to an alert state without conscious disorder. However, he woke up with left upper arm weakness associated with limitation of movement of the left upper limb. The electrophysiological conclusion was left incomplete total brachial plexopathy. Conclusion Ischemia of spinal cordcaused by CO intoxication may be a key mechanism in this case. Hyperbaric oxygen therapy as soon as possible is necessary to prevent peripheral neuropathy after acute CO intoxication. Besides, persisting in rehabilitation training might be important to treat peripheral neuropathy after acute CO intoxication.