Chronic exposure to carbon monoxide produces a clinical syndrome that is often overlooked because of obscure symptomatology, a range of presentations, and lack of awareness of the problem. To help physicians recognize and treat the chronic CO exposure syndrome, the authors present its objective symptomatology, an approach to diagnosis emphasizing neuropsychological tests, a treatment protocol, and theoretical considerations for the mechanism of hyperbaric oxygen's therapeutic action. For elucidation, seven patients treated in the hyperbaric oxygen (HBO) chamber at a tertiary care facility are described. Diagnosis can be facilitated by recognizing the syndrome based on the patient's history, as well as physical and neuropsychological examinations, with emphasis on identifying potential sources of CO exposure. The evaluation and treatment protocols presented, though still experimental, show promise for improving functional, cognitive, and psychiatric capabilities.
Case series of 7 patients, exposed to CO 1 - 18 months (or is it 1 - 36 mos.?), constantly or intermittently. This included 6 women and 1 man. Ages ranged from 23-67 years. Cases were reviewed for length of exposure, the patient's age, whether smoker or non-smoker, CO levels, and symptoms and physical signs of illness. Before treatment with HBO, patients were given a CO neuropsychological screening battery and specific neuropsychological tests. It is not clear from the published report how long or short a time after termination of CO exposure the evaluations were done.
Comprehensive neuropsychological assessment is an essential component of the formal diagnostic work-up, and is more valuable than measurement of COHb. HBO treatment, even when it is delayed weeks after presentation, is of value in improving functional status.
List of Published Symptoms
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