Neuropsychiatric aspects of carbon monoxide poisoning: diagnosis and management

Abstract

SuMMARyCharcoal-burning has become a common method of attempted suicide in Asia and survivors are often intoxicated with carbon monoxide (CO). Reports of the neuropsychiatric aspects of CO poison ing date back to 1914. This article outlines the neuropsychiatric sequelae that have been described secondary to CO poisoning. The under lying pathophysiology and management strategies, including acute management and cognitive rehabilitation, are discussed as these topics are of relevance to psychiatrists. DECLARATION Of INTERESTNone.

Poczucie frustracji i zagubienia w wypowiedziach słownych osób z dysfunkcjami mózgu – mechanizmy neuropsychologiczne. Studia przypadków

“…2009) oraz ubytki słuchu czy tinnitus (czyli tzw. szumy uszne) (Ho, Cheng, Chua, Mak 2012). Ubytki słuchu i tinnitus są efektem hipoksji jądra ślimaka, nerwu VIII i jądra pnia mózgu.…”

Investigation of audible carbon monoxide alarm ownership

“…In analysing the data collected from Liverpool houses, only 9.1 per cent (278 homes out of the 3,044 included in the analysis) reportedly owned one. As the literature review identified, infants, the elderly and those with pre-existing medical conditions such as pulmonary or cardiac disease are more vulnerable to the effects of CO (DEEPAQS, 1994;Townsend and Maynard, 2002;Ho et al, 2012). The following part of the analysis will establish whether these groups had an alarm installed in their properties in the wards highlighted in Figure 1.…”

“…These figures do not take into account those who have been misdiagnosed or have not made their symptoms known to anyone in the medical profession. Croxford et al (2006) estimated that approximately 39,000 homes have appliances that are exposing occupants to high levels of CO. Ho et al (2012) identified that accidental poisoning occurs more commonly in the winter months (Ormandy and Ezratty, 2012). They also noted that the most common causes of accidental poisoning were furnaces, fire, stoves and gas powered room and water heaters.…”

“…Exposure to CO ultimately leads to tissue damage of a greater or lesser extent as tissues are starved of oxygen, leading to neuronal necrosis, apoptosis or cardiac problems (Weaver, 2009;Ryan et al, 2012;Tam et al, 2012). Although CO poisoning can happen to anyone, the most vulnerable are infants, the elderly and anyone with existing pulmonary or cardiac disorders (Department of the Environment Expert Panel on Air Quality Standards (DEEPAQS), 1994; Townsend and Maynard, 2002;Ho et al, 2012).…”

“…Common treatment options 74 SASBE 3,1 are hyperbaric oxygen or normobaric therapy (Kao and Nañ agas, 2006;Weaver, 2009;Ho et al, 2012). However, it should not be assumed that once treatment has been received that the threat of CO is over.…”