Outcome of neurological decompression illness: development of a manifestation-based model

A significant proportion neurological decompression illness cases remain symptomatic after the first recompression treatment. Currently, the factors that predict an incomplete resolution are poorly defined. In this study, 214 cases of neurological decompression illness were reviewed and classified according to the presenting manifestations and outcome after a standard therapeutic regimen. The neurological manifestations were classified by type (loss of sensory or motor function, or loss of consciousness) and then by either the number of sites involved or the location of each manifestation. Cases with both sensory and motor manifestations were less likely to have complete resolution than those with sensory or motor manifestations alone. Cases with manifestations involving the legs were less likely resolve completely than those with manifestations in the arms, especially if both sensory and motor manifestations were reported. Based on these data, a linear logistic model was developed to predict the probability of incomplete resolution after the first recompression treatment depending on the type and location of the manifestations.