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Delayed Leukoencephalopathy after Acute Carbon Monoxide Intoxication in a Married Couple
Korean J Clin Geri 2018 Dec;19(2):101-104
Published online December 30, 2018;  https://doi.org/10.15656/kjcg.2018.19.2.101
Copyright © 2018 The Korean Academy of Clinical Geriatrics.

Seunghee Na1, Jooyeon Im2, Young-Je Heo1, In-Uk Song1

1Departments of Neurology, Incheon St. Mary’s Hospital, The Catholic University of Korea; 2Departments of Radiology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Korea
Received August 20, 2018; Revised October 1, 2018; Accepted October 27, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Carbon monoxide intoxication often causes immediate neurologic deterioration and delayed neurologic sequelae after several weeks from the onset of anoxic event. A 65-year-old woman visited the emergency department with the lack of ability to move or speak for the past two weeks. Brain imaging test identified lesions in the bilateral basal gangli and extensive white matter lesions. Brain imaging findings of her spouse shared the similar findings of the patient. The patient and her spouse reported that both used to sleep in the self-made loess-sedimentary deposit-interior room. One day in the morning, her spouse found the patient with loss of consciousness in this room. When exhaust systems in loess interior spaces do not perform appropriately, amounts of carbon monoxide exceed the safe threshold and lead to an intoxication or near lethal range even in a short period of time such as less than 24 hours since exposure. Timely hyperbaric oxygen therapy can reduce the risk of delayed neurologic sequelae. Any physicians caring older adults with acute loss of consciousness should consider the possibility of carbon monoxide poisoning when witness or caregivers provide loess interior spaces as their living environment, especially, in rural areas.
Keywords : Akinetic mutism, Carbon monoxide poisoning, Complications
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December 2018, 19 (2)