Annals of Indian Academy of Neurology
CASE REPORT
Year
: 2015  |  Volume : 18  |  Issue : 1  |  Page : 108--110

Generalized chorea due to delayed encephalopathy after acute carbon monoxide intoxication


Yueh-Feng Sung1, Ming-Hua Chen2, Giia-Sheun Peng1, Jiunn-Tay Lee1 
1 Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
2 Department of Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan

Correspondence Address:
Yueh-Feng Sung
Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Section 2, Cheng-Gong Road, Neihu 114, Taipei
Taiwan

Movement disorder due to delayed encephalopathy after carbon monoxide (CO) intoxication is uncommon. Generalized chorea, presenting as an initial symptom of delayed encephalopathy, is extremely rare. We describe a 60-year-old woman, who had completely recovered from acute CO poisoning, developed mental and behavioral changes, urinary incontinence and generalized chorea 2 weeks thereafter. T2-weighted brain magnetic resonance imaging showed extensive hyperintensity of the bilateral periventricular and subcortical white matter and the globus pallidus. Brain single-photon emission computed tomography (SPECT) with technetium-99 ethylene cysteine dimer showed inhomogeneous perfusion in the cerebral cortex, with decreased uptake in bilateral frontal regions. Delayed encephalopathy after acute CO intoxication was diagnosed, and the symptoms gradually improved after hyperbaric oxygen therapy (HBOT). This case report demonstrates that generalized chorea may be one of the initial presenting symptoms of delayed encephalopathy after acute CO intoxication. We hypothesize that the generalized chorea in our patient may have been caused by the subcortical white matter lesions, which most likely interrupted the basal ganglia-thalamocortical circuits and that HBOT may be the treatment of choice for such patients.


How to cite this article:
Sung YF, Chen MH, Peng GS, Lee JT. Generalized chorea due to delayed encephalopathy after acute carbon monoxide intoxication.Ann Indian Acad Neurol 2015;18:108-110


How to cite this URL:
Sung YF, Chen MH, Peng GS, Lee JT. Generalized chorea due to delayed encephalopathy after acute carbon monoxide intoxication. Ann Indian Acad Neurol [serial online] 2015 [cited 2020 Sep 18 ];18:108-110
Available from: http://www.annalsofian.org/article.asp?issn=0972-2327;year=2015;volume=18;issue=1;spage=108;epage=110;aulast=Sung;type=0