Delayed choreoathetosis following acute carbon monoxide poisoning

Area of Science:

• Neurology
• Toxicology
• Neuroimaging

Background:

• Carbon monoxide (CO) is a colorless, odorless gas.
• Accidental CO exposure can lead to delayed neurological sequelae.
• Neurological deficits may manifest days to weeks after initial exposure.

Observation:

• A 17-year-old male presented with involuntary, writhing movements (choreoathetosis) affecting his arms, face, and neck.
• The patient also exhibited moderate difficulty with speech (dysarthria).
• These symptoms appeared ten days post-accidental carbon monoxide exposure.

Findings:

• Computed tomography (CT) scans showed symmetric, bilateral infarcts.
• Affected brain regions included the head of the caudate nucleus, putamen, and anterolateral globus pallidus.
• These findings indicate specific patterns of brain injury in the basal ganglia.

Implications:

• This case highlights the potential for delayed and specific basal ganglia injury following carbon monoxide poisoning.
• Understanding these patterns is crucial for diagnosis and management of CO toxicity.
• Neuroimaging plays a vital role in identifying the extent and location of brain damage.