[Bilateral lesions of the basal ganglia as a sign of chronic carbon monoxide intoxication].
A 40-year-old, previously healthy man presented with a subacute coordination disorder and intermittent paraesthesias of the right arm that had begun several months before and had disappeared spontaneously within a few weeks. Neurological examination showed a mildly flattened nasolabial fold on the right side and subtle hypertonia of the right arm. A CT-scan of the brain revealed calcifications in the left caudate nucleus and putamen. Cerebral MRI showed markedly enlarged Virchow-Robin spaces bilaterally in the basal ganglia and extensive periventricular white matter lesions. The differential diagnosis of these radiological findings included carbon monoxide intoxication. Ancillary investigations excluded other causes for the radiological abnormalities, and a defective gas stove that produced carbon monoxide was found in the patient's house. Although carbon monoxide poisoning is relatively rare in the Netherlands, it remains important to be alert to the possibility of such exposure. Radiological findings, notably bilateral lesions of the basal ganglia, may point in the direction of the proper diagnosis.
Haaxma
C A
CA
Universitair Medisch Centrum St Radboud, afd. Neurologie, Postbus 9I0I, 6500 HB Nijmegen.
van Eijk
J J J
JJ
van der Vilet
A M
AM
Renier
W O
WO
Bloem
B R
BR
D000328:Adult; D001479:Basal Ganglia / Q000000981:diagnostic imaging / Q000473:pathology*; D001480:Basal Ganglia Diseases / Q000209:etiology* / Q000473:pathology; D002249:Carbon Monoxide Poisoning / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D003296:Cooking / Q000295:instrumentation; D003937:Diagnosis, Differential; D004868:Equipment Failure; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011699:Putamen / Q000473:pathology; D014057:Tomography, X-Ray Computed