- 期刊
Successful Treatment of Delayed Neuropsychiatric Sequelae in a Carbon Monoxide Intoxication Patient Using Hyperbaric Oxygen-A Case Report and Literature Review
高壓氧成功治療一氧化碳中毒併發之延遲性腦神經精神病變－病例報告與文獻回顧
摘要
一氧化碳中毒是伴隨著合併症和死亡的常見的事件。急性一氧化碳中毒的症狀是無專一性的，例如噁心、嘔吐、疲勞、頭痛或者意識混亂，甚至在更嚴重的神經元損害裡的昏厥或者死亡。在從急性一氧化碳中毒恢復之後，延遲性腦病變是另一個臨床的問題。在臨床以神經學或者精神病學的症狀的反覆發生為特點，且常被誤診為精神病或者藥物濫用等等。我們報告了一病例，起初被誤診為精神病。然而在詳細病史詢問、神經和精神學評估以及影像檢查後，病患被診斷為一氧化碳中毒後之延遲性腦病變，而在高壓氧治療之後症狀明顯改進。因此，在臨床上，我們應該注意在急性一氧化碳中毒在初始恢復之後所跟隨而來的延遲性後遺症以及高壓氣治療通常對這樣的狀況是有用的。
並列摘要
Carbon monoxide (CO) intoxication is a common event which leads to morbidity and mortality. The symptoms of acute carbon monoxide poisoning are non-specific, and include nausea, vomiting, fatigue, headache or confusion, and even coma or death in patients with more serious neuronal damage. Delayed encephalopathy is another clinical problem that may occur after a recovery from the acute stage of carbon monoxide poisoning. It is clinically characterized by a recurrence of neurological or psychiatric symptoms, which are usually misdiagnosed as psychosis or drug abuse, among others. We report herein a patient who was initially misdiagnosed with psychosis. After a detailed history-taking, neurological and psychiatric examination, and imaging studies, he was diagnosed with delayed neuropsychiatric sequelae (DNS) of CO intoxication. The symptoms improved significantly after hyperbaric oxygen therapy. According to our experience in the management of CO intoxication, DNS is easily misdiagnosed due to its non-specific symptoms. Hence, clinically, we should keep in mind delayed sequelae after initial recovery in acute CO intoxication, and that hyperbaric oxygen often works in such a situation.
延伸閱讀
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