J Korean Soc Clin Toxicol.  2015 Jun;13(1):46-49.

Motor Peripheral Neuropathy Involved Bilateral Lower Extremities Following Acute Carbon Monoxide Poisoning: A Case Report

• Choi JH
• Lim H

Abstract

Carbon monoxide (CO) intoxication is a leading cause of severe neuropsychological impairments. Peripheral nerve injury has rarely been reported. Following are brief statements describing the motor peripheral neuropathy involved bilateral lower extremities of a patient who recovered following acute carbon monoxide poisoning. After inhalation of smoke from a fire, a 60-year-old woman experienced bilateral leg weakness without edema or injury. Neurological examination showed diplegia and deep tendon areflexia in lower limbs. There was no sensory deficit in lower extremities, and no cognitive disturbances were detected. Creatine kinase was normal. Electroneuromyogram patterns were compatible with the diagnosis of bilateral axonal injury. Clinical course after normobaric oxygen and rehabilitation therapy was marked by complete recovery of neurological disorders. Peripheral neuropathy is an unusual complication of CO intoxication. Motor peripheral neuropathy involvement of bilateral lower extremities is exceptional. Various mechanisms have been implicated, including nerve compression secondary to rhabdomyolysis, nerve ischemia due to hypoxia, and direct nerve toxicity of carbon monoxide. Prognosis is commonly excellent without sequelae. Emergency physicians should understand the possible-neurologic presentations of CO intoxication and make a proper decision regarding treatment.

Keyword

Peripheral neuropathy; Carbon monoxide; Poisoning

MeSH Terms

Anoxia
Axons
Carbon Monoxide
Carbon Monoxide Poisoning*
Creatine Kinase
Diagnosis
Edema
Emergencies
Female
Fires
Humans
Inhalation
Ischemia
Leg
Lower Extremity*
Middle Aged
Nervous System Diseases
Neurologic Examination
Oxygen
Peripheral Nerve Injuries
Peripheral Nervous System Diseases*
Poisoning
Prognosis
Rehabilitation
Rhabdomyolysis
Smoke
Tendons
Carbon Monoxide
Creatine Kinase
Oxygen
Smoke