[Long-term psychiatric consequences of carbon monoxide poisoning: a case report and literature review].
Carbon monoxide intoxication (COI) can result in severe neuropsychiatric lesions that are however granted little attention in literature. Following the description of affective and neurological symptoms in a 37-year-old female patient five years following COI, we will review, across the literature (Medline 1974--2006), the long-term neuropsychiatric consequences, etiopathogenic hypotheses, prognoses and treatments to apply. Subjective symptoms are reported by the quasi-totality of patients for over more than 30 years following COI. More than half of patients are diagnosed as suffering from cognitive impairments and other neurological symptoms after years following COI. Affective disorders are observed in almost three-fourths of patients and personality disorders in more than half. Numerous cerebral lesions and perfusion disorders can be observed through IRM, PET scan and SPECT and related to the clinical symptomatology of the patient. COI may constitute a risk factor in the waking of long-term neuropsychiatric disorders in a context of environmental and neurobiological complex factor interaction. A close follow-up must be envisaged with neuropsychiatric assessments and regular neuroimagery in order to adapt at best therapeutic interventions to the patient's clinical status. First and foremost prevention and education remain the key solution to the reduction of morbidity and mortality of COI.
Borras
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Consultation secteur Eaux-Vives, division de psychiatrie adulte, département de psychiatrie, hôpitaux universitaires de Genève, 36, rue du XXXI-Décembre, 1207 Genève, Suisse. Laurence.Borras@hcuge.ch
Constant
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De Timary
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Huguelet
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Khazaal
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Y
D000328:Adult; D000368:Aged; D000639:Amitriptyline / Q000008:administration & dosage / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage / Q000627:therapeutic use; D002249:Carbon Monoxide Poisoning / Q000150:complications* / Q000628:therapy; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D003863:Depression / Q000188:drug therapy / Q000209:etiology / Q000628:therapy; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006931:Hyperbaric Oxygenation; D002534:Hypoxia, Brain / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000209:etiology; D001523:Mental Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000534:rehabilitation / Q000628:therapy; D015201:Meta-Analysis as Topic; D009483:Neuropsychological Tests; D011247:Pregnancy; D011613:Psychotherapy; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D000929:Antidepressive Agents, Tricyclic; D000639:Amitriptyline