Delayed neuropsychiatric syndrome after carbon monoxide poisoning.

Abstract

Delayed neuropsychiatric syndrome (DNS) is a well-known complication following carbon monoxide (CO) poisoning and develops in up to 50% of adult survivors. The syndrome is probably immunologically mediated. Common symptoms are slowness, Parkinsonism and cognitive impairment. A woman in her forties started to show gradually increasing symptoms of DNS a few days after an episode of severe CO poisoning. She received methylprednisolone 1g intravenously on 3 consecutive days at around 7 weeks after the poisoning, with an immediate positive response to motor deficit symptoms. Thereafter, she gradually recovered and returned to full-time employment 4.5 months after the steroid treatment. The role of steroids in this patient's recovery is uncertain. However, successful high-dose steroid treatment for patients with ongoing DNS progression after CO poisoning has been reported previously in the literature. The authors recommend more attention to the risk of DNS after CO poisoning and further research on treatment options.