Abstract
The onset of delayed neurological sequelae (DNS) is one of the prognostic factors in the subacute and chronic phases of carbon monoxide (CO) poisoning. The pathophysiology of DNS is associated with neural cell death and demyelination due to ischemia caused by CO exposure. DNS is diagnosed by a lucid interval after acute CO poisoning and delayed onset of neuropsychiatric symptoms such as cognitive and personality changes, parkinsonism, incontinence, dementia, and psychosis. Otherwise, a battery of neuropsychological tests is useful in detecting DNS. The incidence of DNS has been reported to be 0-46% in CO poisoning patients. Consciousness disturbance on admission, age of 36 years or more, higher carboxyl hemoglobin levels, exposure intervals greater than or equal to 24 hr to start the therapy, and elevation in white blood cell count (> 10,000 /μl) were reported as predictive factors for DNS. Hyperbaric oxygen (HBO) therapy might be effective in preventing DNS, but this remains controversial. Further examination is needed to clarify the efficacy of HBO to prevent DNS.
