The Mental and Neurological Sequelae of Carbon Monoxide Asphyxia in a Case Observed for Fifteen Years

Carbon monoxide toxicity: a case series

“…34 It has also been documented that CO has direct toxic effects on the vestibulo-cochlear nerves and the brainstem, which may be responsible for the auditory changes. 28,[35][36][37][38][39] In one study of 78 human patients with CO poisoning, 66.6% had some level of hearing impairment. 40 In another study of 32 human patients with CO poisoning, abnormal BAER tests were found in 8 patients.…”

“…The arterial blood gas revealed a mild metabolic acidosis (pH 7.37, reference range: 7.38-7.42) with a patient's arterial O 2 (PaO 2 ) tension of 332 mmHg at an approximate FiO 2 of 0.40, and an O 2 saturation of 99.8% (reference range: 98-100%). The PaCO 2 was 31 mmHg (reference range: [35][36][37][38][39][40][41][42][43][44][45]) and the base excess was À 3.5 (reference range: À 3.0 to 13.0) showing a mild metabolic acidosis with respiratory compensation. On presentation, the serum COHb levels varied from 5 to 26% (reference range: 0-4%) ( Table 1).…”

Reversible Changes of Brain Perfusion SPECT for Carbon Monoxide Poisoning–Induced Severe Akinetic Mutism

“…16 The sequelae comprised impairments in neurological functions, including concentration, speech, learning, memory, and motor function, accompanied by psychiatric disorders, such as depression, dementia, and psychosis. Patients with typical DNS may also have parkinsonism and cognitive dysfunction, which can develop between 2 and 28 days after acute CO poisoning.…”

“…Patients with typical DNS may also have parkinsonism and cognitive dysfunction, which can develop between 2 and 28 days after acute CO poisoning. [4][5][6][7][8][9][10][11][12][13][14][15][16][17] Our patients were admitted to the hospital with variable presentations of DNS, which later progressed to akinetic mutism. Recent studies have indicated that DNS may be correlated with pathological changes in the brain caused by CO poisoning.…”

Neuropsychological sequelae of carbon monoxide toxicity at eleven-year follow-up

“…The relationship between cerebral oxygen supply and neuropsychological adaptation has been reviewed by Adams, Sawyer, and Kvale (1980). Many victims of nonlethal CO exposure appear to return to premorbid levels of functioning within a few days, but delayed sequelae often emerge within 2-4 weeks after this "pseudorecovery" (Choi, 1983;Jefferson, 1976;Min, 1986;Nardizzi 1979;Noms, Trench, & Hook, 1982;Raskin & Mullaney, 1940;Remick & Miles, 1977;and Smith & Brandon, 1973). Sequelae can include urinary and/or fecal incontinence, gait disturbance, tremor, cardiac damage, verbal aggressiveness, dysarthria, apathy, disorientation, amnesia, mutism, irritability, moodiness, dyspraxia, bizarre expressions, confabulation, depression, delusions, disturbed vegetative functioning, and intellectual deterioration.…”