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Acetylcholinesterase inhibitor treatment alleviated cognitive impairment caused by delayed encephalopathy due to carbon monoxide poisoning: Two case reports and a review of the literature.

Abstract Delayed encephalopathy due to carbon monoxide (CO) poisoning can even occur in patients with mild symptoms of acute CO poisoning. Some cases taking conventional hyperbaric oxygen (HBO) therapy or steroid-pulse therapy may be insufficient, and AchEI may be effective.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28225493
OWN - NLM
STAT- MEDLINE
DA  - 20170222
DCOM- 20170317
LR  - 20170317
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 8
DP  - 2017 Feb
TI  - Acetylcholinesterase inhibitor treatment alleviated cognitive impairment caused
      by delayed encephalopathy due to carbon monoxide poisoning: Two case reports and 
      a review of the literature.
PG  - e6125
LID - 10.1097/MD.0000000000006125 [doi]
AB  - INTRODUCTION: Delayed encephalopathy due to carbon monoxide (CO) poisoning can
      even occur in patients with mild symptoms of acute CO poisoning. Some cases
      taking conventional hyperbaric oxygen (HBO) therapy or steroid-pulse therapy may 
      be insufficient, and AchEI may be effective. PATIENT CONCERNS AND DIAGNOSES: We
      report two cases of delayed encephalopathy after acute CO poisoning involving two
      women aged 69 (Case 1) and 60 years (Case 2) whose cognitive function improved
      with acetylcholinesterase inhibitor (AchEI) treatment. Delayed encephalopathy
      occurred 25 and 35 days after acute CO poisoning in Case 1 and Case 2,
      respectively. Both patients demonstrated cognitive impairment, apathy, and
      hypokinesia on admission. INTERVENTIONS AND OUTCOMES: Although hyperbaric oxygen 
      therapy did not yield any significant improvements, cognitive dysfunction
      improved substantially. This was evidenced by an improved Mini-Mental State
      Examination score ffom 9 to 28 points in Case 1 and an improved Hasegawa's
      dementia rating scale score from 4 to 25 points in Case 2 after administration of
      an AchEI. In Case 1, we administered galantamine hydrobromide, which was related 
      with improved white matter lesions initially detected on brain magnetic resonance
      imaging. However, in Case 2 white matter lesions persisted despite AchEI
      treatment. AchEI treatment may result in improved cognitive and frontal lobe
      function by increasing low acetylcholine concentrations in the hippocampus and
      frontal lobe caused by decreased nicotinic acetylcholine receptor levels in
      delayed encephalopathy after CO poisoning. CONCLUSION: Physicians should consider
      AchEIs for patients demonstrating delayed encephalopathy due to CO poisoning.
FAU - Yanagiha, Kumi
AU  - Yanagiha K
AD  - Department of Neurology, Division of Clinical Medicine, Faculty of Medicine,
      University of Tsukuba, Tsukuba, Ibaraki, Japan.
FAU - Ishii, Kazuhiro
AU  - Ishii K
FAU - Tamaoka, Akira
AU  - Tamaoka A
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Cholinesterase Inhibitors)
RN  - 0 (Nootropic Agents)
SB  - AIM
SB  - IM
MH  - Aged
MH  - Brain Diseases/diagnostic imaging/*drug therapy/*etiology
MH  - Carbon Monoxide Poisoning/*complications/diagnostic imaging/drug therapy
MH  - Cholinesterase Inhibitors/*therapeutic use
MH  - Cognitive Dysfunction/diagnostic imaging/*drug therapy/*etiology
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - Nootropic Agents/therapeutic use
EDAT- 2017/02/23 06:00
MHDA- 2017/03/18 06:00
CRDT- 2017/02/23 06:00
AID - 10.1097/MD.0000000000006125 [doi]
AID - 00005792-201702240-00012 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Feb;96(8):e6125. doi: 10.1097/MD.0000000000006125.

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