Delayed Neuropsychiatric Sequelae after Carbon Monoxide Poisoning: a Case Report and Literature Review

一氧化碳中毒後之神經精神後遺症：一病例報告及文獻回顧

陳俊鴻(Chun-Hung Chen) ； 陳正穎(Chen-Yin Chen) ； 許錦田(Gim-Thean Shiu) ； 林志隆(Chih-Lung Lin) ； 張瑋真(Wei-Chen Chang) ； 楊淵韓(Yuan-Han Yang)

《東港安泰醫護雜誌》 13卷1期 (2007/03) Pp. 41-47

https://doi.org/10.7078/TSMHMNJ.200703.0041

摘要

一氧化碳是一無色、無臭、無味之氣體，每年因一氧化碳中毒而就醫者多有所聞。在台灣，它也是造成自殺或意外死亡的主因之一。一氧化碳中毒除急性期之缺氧、窒息救護外，其神經精神方面的後遺症亦常被提出討論。因其症狀為非專一性，起伏變化易與其他疾病相混淆，故極易被誤判；且至今尚無有效治療與預防之法。在此，我們提出一病例報告；患者於一氧化碳中毒後，經腦部磁振造影顯示兩側基底核有病變。在其出院回家後，於兩個月內逐漸出現健忘、表情木訥及精神運動功能退化之情形。我們回顧相關文獻，討論其臨床症狀、病生理成因與高壓氧治療、piracetam治療一氧化碳中毒後神經精神併發症之病例。

關鍵字

一氧化碳 ； 神經精神後遺症 ； 神經認知 ； 高壓氧治療

並列摘要

Carbon monoxide (CO) poisoning is a common cause of intoxication. It has became a popular cause of poisoning death in Taiwan. It is well known that CO intoxication produces acute neurological reaction, but neuropsychiatric sequelae may be delayed for days or weeks after exposure. We report a case of suicide attempt that developed delayed neuropsychiatric complications after CO poisoning from burning charcoal. The symptoms were characterized by a latent period, followed by insidious and progressive course of neurocognitive dysfunction. The clinical recovery was favorable with a reversible course. We review the etiology, pathophysiology, and compare the management between hyperbaric oxygen therapy and neuroprotective agent. Physician should be aware of the management to reverse and improve the delayed neuropsychiatric sequelae that occur in CO intoxication patients.

並列關鍵字

carbon monoxide ； neuropsychiatric seguelae ； neurocognitive ； hyperbaric oxygen therapy