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[Delayed postanoxic encephalopathy].

F J Gascón Jiménez1, B Navarro Gochicoa, M J Velasco Jabalquinto

  • 1Facultad de Medicina, Unidad Docente de Pediatría, Hospital Universitario Reina Sofía, Departamento de Pediatría, Córdoba.

Anales Espanoles De Pediatria
|November 21, 2000
PubMed
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Delayed postanoxic encephalopathy can occur after benzodiazepine intoxication, causing a relapse of neurological symptoms. This rare condition, affecting the basal ganglia, leads to permanent neurological deficits.

Area of Science:

  • Neuroscience
  • Toxicology
  • Pediatric Neurology

Background:

  • Benzodiazepine intoxication can lead to coma and acute respiratory distress syndrome.
  • Delayed postanoxic encephalopathy is a rare, unexplained neurological condition.
  • This syndrome manifests after an initial hypoxic-ischemic event.

Observation:

  • A 9-year-old boy experienced delayed postanoxic encephalopathy following benzodiazepine intoxication.
  • Initial recovery was followed by the onset of extrapyramidal rigidity and involuntary movements.
  • Brain MRI revealed ischemic changes in the basal ganglia, consistent with anoxic-ischemic encephalopathy.

Findings:

  • The patient presented with lead-pipe rigidity and cogwheel quality in passive movements.
  • Neurological impairment progressed over weeks to months.

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  • The basal ganglia were disproportionately affected compared to the cerebral cortex and white matter.

    • Implications:

    • This case highlights the potential for delayed postanoxic encephalopathy, particularly affecting the basal ganglia.
    • The pathogenesis of this delayed neurological sequela remains unknown.
    • Understanding this phenomenon is crucial for managing patients with severe intoxication and hypoxic events.