Journal of Child Neurology

 

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Journal of Child Neurology, Vol. 21, No. 9, 737-741 (2006)
DOI: 10.1177/08830738060210090401

Neurologic and Radiologic Manifestations of Three Girls Surviving Acute Carbon Monoxide Poisoning

Kam-lun Ellis Hon, FAAP

Department of Paediatrics, The Chinese University of Hong Kong, ehon{at}cuhk.edu.hk.

Wai-lan Yeung, MRCP

Department of Paediatrics, The Chinese University of Hong Kong

Chi-hang Assunta Ho, MRCPCH

Department of Paediatrics, The Chinese University of Hong Kong

Wing-kwan Alex Leung, MRCPCH

Department of Paediatrics, The Chinese University of Hong Kong

Albert Martin Li, MRCP

Department of Paediatrics, The Chinese University of Hong Kong

Winnie Chiu-wing Chu, FRCR

Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong

Yu-leung Chan, FRCR, MD

Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong

We report the neurologic and radiologic manifestations of three adolescent girls with acute carbon monoxide poisoning. The girls were found collapsed and unconscious in a bathroom where liquid petroleum gas was being used as heating fuel. As hyperbaric oxygen therapy was not available locally, they only received oxygen supplementation via nasal cannula (4 L/minute) as treatment in the first 2 days. On transfer to a tertiary center in Hong Kong, evolving neurologic manifestations of visual acuity and field deficits, confusion, and focal motor weaknesses were observed. Focal infarctions were evident in cerebral computed tomography in one patient and cortical lesions on magnetic resonance imaging in all three patients. [18F]Fluorodeoxyglucose (FDG) positron emission tomography (PET) revealed additional decreased metabolism in the basal ganglia in two patients, which was typical of carbon monoxide poisoning. The neurologic deficits resolved completely at 3 weeks after the exposure, but psychologic symptoms succeeded. This report serves to alert clinicians to the varied neuro-ophthalmologic manifestations and psychologic impairment even with the same duration of carbon monoxide poisoning. PET might be more sensitive in detecting cerebral injuries specific for carbon monoxide poisoning. (J Child Neurol 2006;21:737—741; DOI 10.2310/7010.2006.00172).


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