DOI QR코드

DOI QR Code

Delayed Neuropsychiatric Sequalae with Reversible Quadriplegia after Carbon Monoxide Intoxication : A Case Report

일산화탄소에 기인한 Delayed Neuropsychiatric Sequalae 환자에서 발생한 사지 불완전마비 증례보고 1례

  • Ryu, Ju Young (Department of Circulatory Internal Medicine, College of Korean Medicine, Daejeon University) ;
  • Kim, Min Ji (Department of Circulatory Internal Medicine, College of Korean Medicine, Daejeon University) ;
  • Lee, Kang Wook (Department of Circulatory Internal Medicine, College of Korean Medicine, Daejeon University) ;
  • Cho, Hyun Kyoung (Department of Circulatory Internal Medicine, College of Korean Medicine, Daejeon University) ;
  • Yoo, Ho Ryong (Department of Circulatory Internal Medicine, College of Korean Medicine, Daejeon University) ;
  • Seol, In Chan (Department of Circulatory Internal Medicine, College of Korean Medicine, Daejeon University) ;
  • Kim, Yoon Sik (Department of Circulatory Internal Medicine, College of Korean Medicine, Daejeon University)
  • 유주영 (대전대학교 한의과대학 심계내과학교실) ;
  • 김민지 (대전대학교 한의과대학 심계내과학교실) ;
  • 이강욱 (대전대학교 한의과대학 심계내과학교실) ;
  • 조현경 (대전대학교 한의과대학 심계내과학교실) ;
  • 유호룡 (대전대학교 한의과대학 심계내과학교실) ;
  • 설인찬 (대전대학교 한의과대학 심계내과학교실) ;
  • 김윤식 (대전대학교 한의과대학 심계내과학교실)
  • Received : 2018.07.27
  • Accepted : 2018.09.07
  • Published : 2018.09.30

Abstract

Carbon monoxide poisoning leads to hypoxia, which eventually leads to tissue ischemia. The delayed neuropsychiatric syndrome can arise in the period from 4 days to 5 weeks following carbon monoxide poisoning. This case report describes a male who suffered from delayed sequelae after self-inflicted carbon monoxide poisoning. At the time of admission, he had symptoms of quadriplegia, both upper limb ankylosis, gait disturbance, and dysuria. He was treated with acupuncture, electro-acupuncture, physical therapy, and Uwhangchungsim-won. Paraplegia improved considerably after 7 days in hospital, and paralysis of the both upper extremities improved after 14 days in hospital. He was able to walk holding on to his wheelchair after 28 days in hospital. He was hospitalized for 55 days and was discharged from the hospital in a fine condition for everyday life. This case report suggests the possibility that korean medicine for delayed neuropsychiatric syndrome.

Keywords

References

  1. Prockop LD, Chichkova RI. Carbon monoxide intoxication: an updated review. J Neurol Sci. 2007;262(1-2):122-30. https://doi.org/10.1016/j.jns.2007.06.037
  2. Lee JY, Song JH, Lim BS. Characteristics of suicide by carbon monoxide poisoning in Korea. J Korean official statistics. 2016;21(1):57-83.
  3. Weaver LK. Carbon monoxide poisoning. N Engl J Med. 2009;360:1217-25. https://doi.org/10.1056/NEJMcp0808891
  4. Wolf SJ, Lavonas EJ, Sloan EP, Jagoda AS. Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department with Acute Carbon Monoxide Poisoning. Annals of Emergency Medicine. 2008;51:138-152. https://doi.org/10.1016/j.annemergmed.2007.10.012
  5. Kim W, Lee DH, Suh KY. A Clinical Study of Delayed Sequelae in Carbon Monoxide Intoxication. J Korean Neuropsychiatric Assoc. 1987;26(4):675-88.
  6. Lo Pardo D, Amedola D, Senatore G, Damiano A, Pezzuti G, Pugliese N, et al. Delayed neuropsychiatric syndrome after carbon monoxide poisoning: inclusion of hyperbaric oxygen therapy in the recovery protocol. Emergency Care Journal. 2016;12(5675):28-30.
  7. Kim DE, Kim KH, Kim JS, Shin GC, Lee WC. A Case of Delayed encephalopathy after Acute Carbon Monoxied Intoxication. J Korean Oriental Med. 2001;22(3):169-178.
  8. Park JY, Ko JC, Baek EG, Jun CY, Han YH, Ha KS. A Case of Delayed Postanoxic Encephalopathy after Carbon Monoxide Intoxication. J Int Korean Med. 2002;97-102.
  9. Kim YY, Kim JY, Cho HY, Cho SH, Hwang WW. A Case Study of Patient with Delayed Post-Anoxicd Enchphalopathy Improved by Korean Traditional Treatment, Especially Jowiseungchungtang. J of Oriental Neuropsychiatry. 2008;19(3):205-17.
  10. Roh SH, Park SH, Kim MS, Ok HJ, Kwon DI, Sun JJ. A Clinical Case Study of a Delayed Neuropsychic logical Sequelae Patient with Abnormal Brain Waves due to CO Intoxication. J Int Korean Med. 2014;233-239
  11. Zhang J, Piantadosi CA. Mitochondrial oxidative stress after carbon monoxide hypoxia in the rat brain. Journal of Clinical Investigation. 1992;90(4):1193-9. https://doi.org/10.1172/JCI115980
  12. Thom SR, Elbuken ME. Oxygen-dependent antagonism of lipid peroxidation. Free Radic Biol Med. 1991;10(6):413-26. https://doi.org/10.1016/0891-5849(91)90050-D
  13. Kim JH, Chang KH, Song IC, Kim KH, Kwon BJ, Kim HC, et al. Delayed encephalopathy of acute carbon monoxide intoxication: Diffusivity of cerebral white matter lesions. AJNR Am J Neuroradiol. 2003;24(8):1592-7.
  14. Choi IJ, Oh YH, Kim GT. Original Articles: Magnetic Resonance Imaging for the Prediction of Delayed Neuro-psychiatric Sequelae in Patients with Carbon Monoxide Poisoning DNS. J Korean Soc Emerg Med. 2013;24(2):164-73.
  15. Parkinson RB, Hopkins RO, Cleavinger HB, Weaver LK, Victoroff J, Foley JF, et al. White matter hyperintensities and neuropsychological outcome following carbon monoxide poisoning. Neurology. 2002;58(10):1525-32. https://doi.org/10.1212/WNL.58.10.1525
  16. Jian-Fang Z, Qiming G, Hua S, Bin L, Yuxiu D, Maofeng L, et al. A positive Babinski reflex predicts delayed neuropsychiatric sequelae in Chinese patients with carbon monoxide poisoning. Biomed Res Int. Epub May 15, 2014.
  17. Beppu T. TThe role of MR imaging in assessment of brain damage from carbon monoxide poisoning: a review of the literature. AJNR Am J Neuroradiol. 2014 Apr;35(4):625-31. https://doi.org/10.3174/ajnr.A3489
  18. Chang DC, Lee JT, Lo CP, Fan YM, Huang KL, Kang BH, et al. Hyperbaric oxygen ameliorates delayed neuropsychiatric syndrome of carbon monoxide poisoning. Undersea Hyperb Med. 2010 Jan-Feb;37(1):23-33.
  19. Park HK, Joo SH, Choi JW, Park HS. A case of delayed encephalopathy of carbon monoxide intoxication. J Korean Neuropsychiatr Assoc. 2013;52:463-467. https://doi.org/10.4306/jknpa.2013.52.6.463
  20. Lee SH, Shin KH, Kim JU. Effect of Seven Points of CVA Acupuncture on Cerebral Blood Flow. J Acupunct Res. 2004;21(3):83-97.
  21. Lee SW, Yun JM, Son JW, Kang BG, Park SM, Yun HJ, et al. The Effect of Electroacupuncture on Upper-Extremity Spasticity of Stroke Patients. J Int Korean Med. 2007;28(3):492-501.
  22. Yoo YD, Kim SY, Min SG. Effects of Electroacupuncture and Therapeutic Exercise on Skeletal Muscle in the Ischemic Stoke Rats. J Korean Society of Physical Therapy. 2006;18(3):9-21.
  23. Heo J, (Remark by Jinjupyo). Donguibogam. 2nd rev. ed. Seoul:Bubinbooks. 2009:1026.
  24. Kim LD, Yun SP, Lee SH, Kim EJ, Na BJ, Jung DW, et al. Effects of Uwhangchungsim-won (Niuhuangqingxin-yuan) on Systemic Blood Pressure, Pulse Rate, Cerebral Blood Flow, and Cerebrovascular Reactivity in Humans. J Int Korean Med. 2004;25(3):440-50.

Cited by

  1. 일산화탄소 중독에 의한 Delayed Neuropsychiatric Sequalae 환자 치험 1례 vol.40, pp.5, 2018, https://doi.org/10.22246/jikm.2019.40.5.957
  2. CARE 지침에 따른 대한한의학회지의 증례 보고에 대한 질 평가 연구: 2015년~2020년 증례 보고를 중심으로 vol.41, pp.2, 2018, https://doi.org/10.13048/jkm.20016
  3. CARE 지침에 따른 대한한의학회지의 증례보고에 대한 질 평가 vol.41, pp.2, 2018, https://doi.org/10.13048/jkm.20019