This delayed form is also called post interval syndrome, and can present up to 1 month after initial exposure (14 45 days).3 Failure to suspect on the initial presentation often predisposes to late sequelae. [japi.org]

Among the 141 patients who presented to the first follow-up visit, 108 presented at admission signs or symptoms currently considered indications for HBO in our hospital. [sjtrem.biomedcentral.com]

This has been called post-interval syndrome, which can present after an apparent period of normalcy following acute poisoning. [pubmed.ncbi.nlm.nih.gov]

Case Presentation A previously healthy 33-year-old woman was found unconscious at her house. She was exposed to CO from a faulty heater and the exposure time was unknown. [ncbi.nlm.nih.gov]

In this article, we present a case of carbon monoxide poisoning with a delayed neurological sequela. The following review summarizes the literature on clinical presentation, diagnostic options, pathophysiology and therapy of this disease. [thieme-connect.com]

• Movement Disorder

  The examination detected no focal signs, myoclonias, or movement disorders. All laboratory analyses showed normal results, and the VDRL and HIV tests were both negative. [elsevier.es]

  There was no clinical response to a tricyclic antidepressant, but both the mood and movement disorders responded fully to L-dopa. [pubmed.ncbi.nlm.nih.gov]

  Less well known are symptoms that occur with a delay of 2–40 days, such as movement disorders, cognitive impairment or affective disorders. In this article, we present a case of carbon monoxide poisoning with a delayed neurological sequela. [thieme-connect.com]

  Some survivors of CO poisoning develop, after a lucid interval, a potentially permanent encephalopathy in the form of cognitive impairment and movement disorders, such as Parkinsonism. [ncbi.nlm.nih.gov]

• Unconsciousness

  He was found unconscious in the driver's seat of his vehicle in an indoor garage the morning before. An estimated 7 h later, he was comatose and taken to a nearby village clinic. Oxygen was administered immediately. [pubmed.ncbi.nlm.nih.gov]

  He was found unconscious in that room the next morning. The treating physician at the local hospital made a diagnosis of acute carbon monoxide poisoning and treated accordingly. [japi.org]

  Case Presentation A previously healthy 33-year-old woman was found unconscious at her house. She was exposed to CO from a faulty heater and the exposure time was unknown. [ncbi.nlm.nih.gov]

• Hypothermia

  Similar articles Severe carbon monoxide poisoning complicated by hypothermia: a case report. Kamijo Y, Ide T, Ide A, Soma K. Kamijo Y, et al. Am J Emerg Med. 2011 Mar;29(3):357.e5-7. doi: 10.1016/j.ajem.2010.04.011. Epub 2010 Aug 2. [pubmed.ncbi.nlm.nih.gov]

• Nausea

  © Introduction Carbon monoxide poisoning can have two phases of presentation an acute phase characterized by headache, dizziness, confusion, nausea, seizures and coma, and a delayed encephalopathy clinically characterized by a recurrence of neurologic [japi.org]

  Presenting symptoms are notoriously aspecific (headache, asthenia, nausea, vomiting, transient loss of consciousness, altered mental status, coma) and correct diagnosis is a challenge for the emergency physician. [sjtrem.biomedcentral.com]

  She was last heard by her relatives 10 hours earlier, when she referred experiencing nausea, vomiting, and headache. She was admitted to intensive care unit (ICU) with a Glasgow Coma Scale score of 9/15 (E4-M3-V2). [ncbi.nlm.nih.gov]

• Vomiting

  Presenting symptoms are notoriously aspecific (headache, asthenia, nausea, vomiting, transient loss of consciousness, altered mental status, coma) and correct diagnosis is a challenge for the emergency physician. [sjtrem.biomedcentral.com]

  She was last heard by her relatives 10 hours earlier, when she referred experiencing nausea, vomiting, and headache. She was admitted to intensive care unit (ICU) with a Glasgow Coma Scale score of 9/15 (E4-M3-V2). [ncbi.nlm.nih.gov]

• Encephalopathy

  Cognitive recovery after delayed carbon monoxide encephalopathy. Clin Neurol Neurosurg, 107 (2005), pp. 347-350 [9] M.C. Hu, I.S. Shiah, C.B. Yeh, H.K. Chen, C.K. Chen. Ziprasidone in the treatment of delayed carbon monoxide encephalopathy. [elsevier.es]

  Studies have shown that treatment with hyperbaric oxygen can offer some protection against delayed encephalopathy. [japi.org]

  [Related factors for the development of delayed encephalopathy following acute carbon monoxide poisoning]. Qin J. Qin J. Zhonghua Yu Fang Yi Xue Za Zhi. 1992 Jan;26(1):25-7. Zhonghua Yu Fang Yi Xue Za Zhi. 1992. PMID: 1606869 Chinese. [pubmed.ncbi.nlm.nih.gov]

  Delayed encephalopathy of acute carbon monoxide intoxication: diffusivity of cerebral white matter lesions. AJNR Am J Neuroradiol 2003; 24: 1592-1597 41 Chu K, Jung KH, Kim HJ. et al. [thieme-connect.com]

• Headache

  Isolated neurological symptoms such as gesture apraxia and single seizures have been ascribed to carbon monoxide poisoning, as has "winter headache." [proz.com]

  © Introduction Carbon monoxide poisoning can have two phases of presentation an acute phase characterized by headache, dizziness, confusion, nausea, seizures and coma, and a delayed encephalopathy clinically characterized by a recurrence of neurologic [japi.org]

  There was no significant correlation with age, sex, voluntary exposure, headache, transient loss of consciousness, GCS between 14 and 9, arterial lactate and carboxyhemoglobin concentration. [sjtrem.biomedcentral.com]

  Its clinical manifestations vary from symptoms like mild headache and dizziness to more serious issues including death. [thieme-connect.com]

  The clinical symptoms range from headache and confusion to coma and death, with mortality rates reaching up to 3%. CO is a nonirritant gas generated during the incomplete combustion of carbon-based compounds. [ncbi.nlm.nih.gov]

• Confusion

  © Introduction Carbon monoxide poisoning can have two phases of presentation an acute phase characterized by headache, dizziness, confusion, nausea, seizures and coma, and a delayed encephalopathy clinically characterized by a recurrence of neurologic [japi.org]

  After that initial month, his wife noticed changes in his behaviour: he was apathetic, disoriented, confused, and had difficulty completing professional and other daily tasks. [elsevier.es]

  The clinical symptoms range from headache and confusion to coma and death, with mortality rates reaching up to 3%. CO is a nonirritant gas generated during the incomplete combustion of carbon-based compounds. [ncbi.nlm.nih.gov]

• Altered Mental Status

  A 24-y-old driver was admitted to the University-based emergency department with altered mental status. He was found unconscious in the driver's seat of his vehicle in an indoor garage the morning before. [pubmed.ncbi.nlm.nih.gov]

  mental status, abnormal neurological signs, myocardial injury and severe metabolic acidosis. [sjtrem.biomedcentral.com]

• Ataxia

  Patients present with cognitive impairment, akinetic mutism, sphincter involvement, gait ataxia and various extra-pyramidal problems in the form of chorea, dystonia and parkinsonism MRI is the most sensitive diagnostic tool. [japi.org]

  Its main symptoms are cognitive impairment, parkinsonism, ataxia, and/or behavioural disorder.1–3 We report the case of a patient who presented this entity, which is characterised by pronounced cognitive impairment. [elsevier.es]

The utility of CAT in the diagnostic workup and in following clinical course is discussed, as are the difficulties of making a diagnosis of an antecedent primary psychiatric disorder in the presence of neurological and psychiatric sequelae of CO intoxication [pubmed.ncbi.nlm.nih.gov]

Ziprasidone in the treatment of delayed carbon monoxide encephalopathy. Prog Neuropsychopharmacol Biol Psychatry, 30 (2006), pp. 755-757 [10] P. Wang, T. Zeng, Z.F. Chi. [elsevier.es]

Rehabilitative treatment was performed concurrently with HBOT and ROS scavenger administration. [ncbi.nlm.nih.gov]

Mortality among patients admitted to the hospital is low, and prevention of delayed neuropsychological sequelae (DNS) has become the main goal of treatment. [sjtrem.biomedcentral.com]

PMID: 15172716 [The guideline 'Treatment of acute carbon-monoxide poisoning' from doctors in clinics with a tank for hyperbaric ventilation]. de Pont AC. de Pont AC. Ned Tijdschr Geneeskd. 2006 Mar 25;150(12):665-9. Ned Tijdschr Geneeskd. 2006. [pubmed.ncbi.nlm.nih.gov]

Studies have shown that treatment with hyperbaric oxygen can offer some protection against delayed encephalopathy. [japi.org]

Factors affecting the prognosis of patients with delayed encephalopathy after acute carbon monoxide poisoning. Am J Emerg Med, 29 (2011), pp. 261-264 [3] C.L. Hsiao, H.C. Kuo, C.C. Huang. [elsevier.es]

Unexpected late manifestation and favorable prognosis]. Garrels L, Folkerts H. Garrels L, et al. Nervenarzt. 1996 Aug;67(8):682-5. doi: 10.1007/s001150050041. Nervenarzt. 1996. PMID: 8805114 German. [pubmed.ncbi.nlm.nih.gov]

Subcortical white matter changes are frequent and imaging studies roughly correlates with prognosis.1 Predictors of delayed encephalopathy at the time of acute presentation include syncope, depressed level of consciousness at the time of presentation, [japi.org]

The implications of these findings with regard to the central neurochemical pathophysiology in this patient and in major depressive disorder in general are discussed. [pubmed.ncbi.nlm.nih.gov]

[…] behavioural sequelae, and movement disorders.1,2 Prognosis is less favourable in elderly patients or those with shorter lucid intervals (defined as the latency period between acute poisoning and the onset of neuropsychological symptoms).1,2 The main pathophysiological [elsevier.es]

The following review summarizes the literature on clinical presentation, diagnostic options, pathophysiology and therapy of this disease. [thieme-connect.com]

The pathophysiology of DNS is not completely understood, though some authors suggested that the typical white matter involvement in CO poisoning reflects a transient intramyelinic edema or inflammation, due to brain lipid peroxidation [6, 7]. [ncbi.nlm.nih.gov]

Yet this syndrome is both preventable and treatable if the true cause is recognised. [proz.com]

Furthermore, whether antiinflammatory therapy could prevent DNS is unknown [1, 16]. [sjtrem.biomedcentral.com]

Delayed neuropsychologic sequelae after carbon monoxide poisoning: prevention by treatment with hyperbaric oxygen. Ann Emerg Med, 25 (1995), pp. 474-480 [7] B. Gilmer, J. Kilkenny, C. Tomaszewski, J.A. Watts. [elsevier.es]

Concurrent use of antioxidants and anti-inflammatory drugs may prevent the side effects of oxygen therapy at supraphysiological pressure due to oxidative stress. [pubmed.ncbi.nlm.nih.gov]