Reza Bidaki; Azadeh Rahavi; Farzaneh Dehghani; Mohamad Ebrahim Ghanei; Najmeh Zaer-Alhosseini; Maryam Khorasani
Abstract
Introduction: Carbon monoxide (CO) poisoning is a prevalent lethal condition. The clinical feature of this type of poisoning varies from headache and nausea to more severe conditions. After recovery from the acute intoxication, neurological or behavioral problems may emerge. In 3%-40% of cases, delayed ...
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Introduction: Carbon monoxide (CO) poisoning is a prevalent lethal condition. The clinical feature of this type of poisoning varies from headache and nausea to more severe conditions. After recovery from the acute intoxication, neurological or behavioral problems may emerge. In 3%-40% of cases, delayed neuropsychiatric syndrome (DNS) in post CO poisoning, generally develops within few weeks after a preliminary remission from acute poisoning. Case Presentation: We report a patient with relatively suitable premorbid. He was admitted to the hospital with fire burning, co poisoning and discharged home with good general conditions and mental status by receiving normal baric oxygen 100%. later in post-operative management of skin graft he developed a fulminant neurological deficit by impaired memory and concentration, loosening of association, disorientation to place, time and person, agitation, aggression, mood labiality, urinary incontinency and encopresis, slow psychomotor retardation, false and approximate answers to questions, auditory and visual hallucination, staring and inappropriate laughing. As the patient was not responsive to neurological treatment, he was referred to psychiatric service. DNS in this patient resolved gradually during a short period of psychopharmacotherapy and supportive psychotherapy. Conclusion: CO poisoning may lead to neuropsychiatric sequel and neuroimaging changes which could be reversible.
Reza Bidaki; Seyed Nader Mostafavi; Sogol Al-Saeed; Motahhareh Karimoddini; Farzaneh Dehghani
Abstract
Introduction: Parquet poisoning has been elaborated to be very common among developing countries, particularly in regions with agriculture economy. One of the most common presentations of paraquat poisoning is oropharyngeal burns. Herein, we report a patient from a dry and warm district in the geographic ...
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Introduction: Parquet poisoning has been elaborated to be very common among developing countries, particularly in regions with agriculture economy. One of the most common presentations of paraquat poisoning is oropharyngeal burns. Herein, we report a patient from a dry and warm district in the geographic center of Iran where agriculture and, as a result, paraquat poisoning are not commonly reported. Case Presentation: A 25-year-old man presented to hospital subsequent to a suicide attempt by ingesting oral paraquat poison. He gradually developed odynophagia and trismus-like appearance that, after a psychiatric consultation, was misdiagnosed as a drug side effect in the form of dystonia. Upon further physical examination, oral ulcers on his tongue were revealed to be responsible for the symptom. Conclusion: Paraquat poisoning is very rare in regions with lower rates of agriculture activities. In any patient with poisoning, however, it is necessary to consider intraoral examination to rule out any other suspected diagnosis.