Delayed Neurological Sequelae Successfully Treated with Adjuvant, Prolonged Hyperbaric Oxygen Therapy: Review and...

Area of Science:

• Neurology
• Toxicology
• Hyperbaric Medicine

Background:

• Carbon monoxide (CO) intoxication is a significant cause of mortality and morbidity globally.
• Delayed diagnosis and treatment are common due to environmental detection challenges and subtle symptoms.
• Existing research primarily addresses acute CO intoxication, neglecting Delayed Neurological Sequelae (DNS) and its management.

Observation:

• Two patients presented with severe neurological impairment and characteristic brain demyelination weeks after CO exposure, diagnosed as DNS.
• Magnetic resonance imaging (MRI) confirmed diffused demyelination in both cases.
• Patients received prolonged treatment including hyperbaric oxygen (HBO), intravenous corticosteroids, and rehabilitation.

Findings:

• Complete resolution of clinical and radiological features of DNS was observed post-treatment.
• Neurological status returned to normal in both patients.
• This suggests a potential therapeutic benefit of combined HBO, corticosteroids, and rehabilitation for DNS.

Implications:

• These findings highlight the importance of vigilant clinical follow-up for CO intoxication survivors.
• The successful treatment of these rare DNS cases warrants further investigation and high-quality studies.
• Early and aggressive multimodal therapy may be crucial for managing severe Delayed Neurological Sequelae.