We performed hyperbaric oxygen (HBO) therapy for 3 patients with delayed neuropsychiatric encephalopathy induced by carbon monoxide (CO) poisoning. All patients were male and around 50 years old, and they had not received HBO therapy within 24 h after CO poisoning, even though they showed severe consciousness disturbance. In these patients, delayed neuropsychiatric encephalopathy appeared about 25 days after acute CO poisoning, and HBO therapy was initiated within 8 days after disease onset. Although the condition of 2 of the patients worsened initially, they showed significant improvement of neurocognitive impairment after 30 sessions of HBO therapy. The clinical courses of these patients suggest that the effect of HBO therapy can be evaluated after 30 sessions. To evaluate the validity of the indices of the clinical effect of HBO therapy, we performed brain magnetic resonance imaging, single photon emission computed tomography, electroencephalography (EEG), and neurocognitive tests (HDS-R, and Wechsler Adult Intelligence Scale-Revised or III). Our results showed that changes in EEG signals and neurocognitive tests were closely correlated with the patients' clinical courses.
<Authors' abstract>
Clinical Examination of 3 Patients with Delayed Neuropsychiatric Encephalopathy Induced by Carbon Monoxide Poisoning, Who Recovered from Severe Neurocognitive Impairment by Repetitive Hyperbaric Oxygen Therapy
1 Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine
2 Department of Psychiatry, National Medical Organization Kanmon Medical Center
3 Advanced Medical Emergency & Critical Care Center, Yamaguchi University Hospital
2 Department of Psychiatry, National Medical Organization Kanmon Medical Center
3 Advanced Medical Emergency & Critical Care Center, Yamaguchi University Hospital
Psychiatria et Neurologia Japonica
116: 659-669, 2014
Accepted in revised form: 1 February 2014.
Accepted in revised form: 1 February 2014.
＜Keywords：delayed neuropsychiatric encephalopathy induced by carbon monoxide poisoning, hyperbaric oxygen therapy, indices of the clinical effect, disturbances of cognitive functions, neurocognitive test＞
