Delayed Encephalopathy Following Carbon Monoxide Poisoning

一氧化碳中毒之遲發性腦病變

陳衛智(Wei-Chih Chen) ； 蔡鴻池(Hung-Chih Tsai)

《北市醫學雜誌》 7卷4期 (2010/12) Pp. 368-374

https://doi.org/10.6200/TCMJ.2010.7.4.05

摘要

一氧化碳中毒引起的遲發性腦病變可能有嚴重的併發症。於復發前常伴隨著一段不等時間之假癒期。其發病機轉至今仍無法解釋。我們在此報告1例一氧化碳中毒患者其認知功能在第2天及第33天分別發生兩次腦病變症狀。住院期間由於雙下肢肌張力異常本院進行神經傳導及肌電圖檢查，結果顯示雙邊坐骨神經病變。於是我們安排病患開始物理治療、職能治療及語言治療，經歷六個月復健治療，目前病人已可以使用助行器協助走路，並持續再追蹤六個月後情況良好，無復發跡象。

關鍵字

一氧化碳中毒 ； 遲發性腦病變

並列摘要

Delayed encephalopathy due to carbon monoxide intoxication is clinically characterized by a recurrence of neurological or psychiatric symptoms. This recurrence is preceded by a temporary asymptomatic period (lucid interval) that is of variable duration (usually 2-3 weeks) after recovery from the acute stage CO intoxication. The underlying pathological lesion is thought to be diffuse demyelination of the cerebral white matter; however, the mechanism causing the pathogenesis remains unexplained. Here, we report a case of delayed encephalopathy characterized by the patient suffering from two episodes of cognitive dysfunction on Day 2 and Day 33 after carbon monoxide intoxication. Tests were performed during hospitalization that revealed bilateral sciatic neuropathy. The patient can now feed herself and walk with the assistance of a walker.

並列關鍵字

delayed encephalopathy ； carbon monoxide poisoning