title: Atypical parkinsonism and motor neuron syndrome in a Biosphere 2 participant: a possible complication of chronic hypoxia and carbon monoxide toxicity?
abstract: Exogenous toxins and chronic hypoxia have been implicated in the etiopathogenesis of a variety of neurological disorders, but it is not always possible to establish a cause-effect relationships. We describe a patient who presented with an unusual gait disorder and progressive motor neuron disease after residing for 2 years within Biosphere 2, a scientifically engineered dome, tightly sealed to allow miniscule exchange of air between its atmosphere and the earth's atmosphere. We postulate that this unusual syndrome resulted from chronic hypoxia possibly coupled with carbon monoxide and nitrous oxide exposure.
authors.affiliation: Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: Brian K
authors.initials: BK
authors.lastname: Lassinger
authors.forename: Carolyn
authors.initials: C
authors.lastname: Kwak
authors.forename: Roy L
authors.initials: RL
authors.lastname: Walford
authors.forename: Joseph
authors.initials: J
authors.lastname: Jankovic
mesh_terms: D000368:Aged; D001921:Brain / Q000187:drug effects / Q000473:pathology / Q000503:physiopathology; D002248:Carbon Monoxide / Q000009:adverse effects*; D002908:Chronic Disease; D005684:Gait; D006801:Humans; D000860:Hypoxia / Q000139:chemically induced* / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D016472:Motor Neuron Disease / Q000473:pathology / Q000503:physiopathology*; D009333:Neck; D009609:Nitrous Oxide / Q000009:adverse effects*; D010101:Oxygen Consumption; D020734:Parkinsonian Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D012720:Severity of Illness Index; D013128:Spinal Osteophytosis / Q000473:pathology
chemical_list: D002248:Carbon Monoxide; D009609:Nitrous Oxide