A Case of Delayed Encephalopathy of Carbon Monoxide Intoxication

C. Hyung Keun Park; Suk-Hyun Joo; Jung-Won Choi; Hanson Park

doi:10.4306/jknpa.2013.52.6.463

Journal List > J Korean Neuropsychiatr Assoc > v.52(6) > 1017663

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Park, Joo, Choi, and Park: A Case of Delayed Encephalopathy of Carbon Monoxide Intoxication

Case Report

Journal of Korean Neuropsychiatric Association 2013; 52(6): 463-467.

Published online: 30 November 2013

DOI: https://doi.org/10.4306/jknpa.2013.52.6.463

A Case of Delayed Encephalopathy of Carbon Monoxide Intoxication

C. Hyung Keun Park, MD^1,², Suk-Hyun Joo, MD³, Jung-Won Choi, MD⁴, Hanson Park, MD^2,⁵

¹Department of Psychiatry, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.

²Department of Psychiatry, St. Andrews Neuropsychiatric Hospital, Icheon, Korea.

³Sinseiran Diagnostic Radiology Clinic, Icheon, Korea.

⁴Center of Child and Adolescent Psychiatry, Seoul National Hospital, Seoul, Korea.

⁵Department of Anthropology, College of Social Science, Seoul National University, Seoul, Korea.

Address for correspondence: Hanson Park, MD. Department of Psychiatry, St. Andrews Neuropsychiatric Hospital, 109-84 Seoicheon-ro 320beon-gil, Icheon 467-813, Korea. Tel +82-31-639-3700, Fax +82-31-639-3730, parkhanson@gmail.com

Received 1 August 2013 Revised 28 September 2013 Accepted 30 September 2013

Abstract

Occurrence of carbon monoxide intoxication has decreased due to decline in use of coal briquettes (anthracite) in Korea. However, suicide attempt by use of a coal fire lighter (beon-gae-tan) has shown a rapid increase over the past five years with relevance to imitated suicide. Acute carbon monoxide intoxication is a dangerous problem affecting the brain, kidney, lung, and other major organs. Sometimes, delayed encephalopathy after carbon monoxide intoxication makes clinical psychiatric diagnosis and treatment puzzling because neuropsychiatric sequelae are ambiguous with premorbid psychiatric problems, such as mood disorder, psychotic disorder, or other substance dependence. We report on a case of delayed encephalopathy of carbon monoxide intoxication and discuss its diagnosis and management.

Keywords: Carbon monoxide, Encephalopathy, Suicide, Addiction, Briquette, Anthracite

Figures and Tables

Fig. 1

(T2W/FLAIR) Diffuse demyelination on the centrum semiovale in the white matter of both hemisphere (arrow).

Fig. 2

(T2W/FLAIR) High signal of central globus pallidus, which is the typical finding of acute carbon monoxide intoxication, is not found. Anatomical structure of basal ganglia is deformed with leukomalasia of surrounding white matter (arrow).

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