Adir Y, Bentur Y, Melamed Y
Israel Navy Hyperbaric Institute, Haifa.
Harefuah. 1992 May 1;122(9):562-3, 616.
A broad range of neuropsychiatric abnormalities, including dementia, psychosis, and parkinsonism, as well as almost every known neurologic syndrome, can occur following carbon monoxide (CO) poisoning. These symptoms develop 2-40 days (usually 2-3 weeks), after initial exposure. There is an incidence of recurrence of up to 40%. However, in recent years the neuropsychiatric sequelae appear to have been occurring less frequently, perhaps as a direct result of the use of hyperbaric oxygen (HBO) therapy. There is no specific therapy for this complication, but up to 75% recover within 12-18 months. Myers et al. (Ann Emerg Med, 14: 1163, 1985) found HBO to be effective for the neuropsychiatric sequelae. We report a 19-year-old man who developed late psychiatric disturbances despite the use of HBO for acute CO intoxication. The neuropsychiatric symptoms, which developed 3 days after full recovery of consciousness, resolved completely when HBO therapy was reinstituted. 6 months later he was functioning normally with no neuropsychiatric symptoms.
一氧化碳(CO)中毒后可出现广泛的神经精神异常,包括痴呆、精神病和帕金森综合征,以及几乎所有已知的神经综合征。这些症状在初次接触后2至40天(通常为2至3周)出现。复发率高达40%。然而,近年来神经精神后遗症的发生率似乎有所降低,这可能是高压氧(HBO)治疗应用的直接结果。对于这种并发症没有特效治疗方法,但高达75%的患者在12至18个月内康复。迈尔斯等人(《急诊医学杂志》,14:1163,1985年)发现高压氧对神经精神后遗症有效。我们报告一名19岁男性,尽管因急性CO中毒接受了高压氧治疗,但仍出现了迟发性精神障碍。神经精神症状在意识完全恢复3天后出现,但重新进行高压氧治疗后症状完全消失。6个月后,他功能正常,没有神经精神症状。