Delayed Post-Hypoxic Leukoencephalopathy: Case Report with a Review of Disease Pathophysiology
Open Access
- 21 July 2013
- journal article
- case report
- Published by MDPI AG in Neurology International
- Vol. 5 (3), 41-44
- https://doi.org/10.4081/ni.2013.e13
Abstract
Delayed post-hypoxic leukoencephalopathy is a rare clinical phenomenon usually observed in a small number of carbon monoxide poisoning survivors. A similar phenomenon is reported here in a patient who successfully recovered from a large overdose of diazepam and methadone, but then abruptly declined 3 weeks after the initial event. Magnetic resnance revealed confluent white matter hyperintensity on fluid-attenuated inversion recovery and T2 weighted sequences, and spectroscopy revealed elevated peaks in choline, creatinine, and lactate. Analysis and review of the literature suggests this phenomenon occurs on average about 19 days after the initial event. Although the pathophysiology remains obscure, it is noted here that the mean lucid interval coincides approximately with the replacement half-life for myelin related lipids and proteins.Keywords
This publication has 19 references indexed in Scilit:
- Delayed Post-Hypoxic LeukoencephalopathyPsychosomatics, 2001
- Neuronal damage in the interval form of CO poisoning determined by serial diffusion weighted magnetic resonance imaging plus 1H-magnetic resonance spectroscopyJournal of Neurology, Neurosurgery & Psychiatry, 2001
- Positron Emission Tomography Measures of Benzodiazepine Binding in Alzheimer's DiseaseArchives of Neurology, 1995
- Cerebral metabolic changes in delayed carbon monoxide sequelae studied by proton MR spectroscopyNeuroradiology, 1994
- Delayed encephalopathy after acute carbon monoxide intoxication: MR imaging features and distribution of cerebral white matter lesions.Radiology, 1992
- Delayed Neurologic Sequelae in Carbon Monoxide IntoxicationArchives of Neurology, 1983
- The effect of enzyme induction on diazepam metabolism in man.British Journal of Clinical Pharmacology, 1979
- Synthesis and turnover of cerebrosides and phosphatidylserine of myelin and microsomal fractions of adult and developing rat brainBiochemical Journal, 1976
- Hypoxic-Ischemic Leukoencephalopathy in ManArchives of Neurology, 1976
- Delayed Neurological Deterioration After AnoxiaArchives of Internal Medicine, 1962