Skip to main content Accessibility help
×
×
Home

Neuropsychiatric aspects of carbon monoxide poisoning: diagnosis and management

  • Roger Chun Man Ho, Wendy Cheng, Anna Nyap Cheng Chua and Anselm Mak

Summary

Charcoal-burning has become a common method of attempted suicide in Asia and survivors are often intoxicated with carbon monoxide (CO). Reports of the neuropsychiatric aspects of CO poisoning date back to 1914. This article outlines the neuropsychiatric sequelae that have been described secondary to CO poisoning. The underlying pathophysiology and management strategies, including acute management and cognitive rehabilitation, are discussed as these topics are of relevance to psychiatrists.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Neuropsychiatric aspects of carbon monoxide poisoning: diagnosis and management
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Neuropsychiatric aspects of carbon monoxide poisoning: diagnosis and management
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Neuropsychiatric aspects of carbon monoxide poisoning: diagnosis and management
      Available formats
      ×

Copyright

Corresponding author

Dr Roger Chun Man Ho, Department of Psychological Medicine, National University Hospital, 5 Lower Kent Ridge Road, Singapore 110974. Email: pcmrhcm@nus.edu.sg

Footnotes

Hide All

Declaration of Interest

None.

Footnotes

References

Hide All
Bergquist, TF, Malec, JF (1997) Psychology: current practice and training issues in treatment of cognitive dysfunction. Neurorehabilitation 45: 112–29.
Blumenthal, I (2001) Carbon monoxide poisoning. Journal of Royal Society of Medicine 94: 270–2.
Caine, D, Watson, JD (2000) Neuropsychological and neuropathological sequelae of cerebral anoxia: a critical review. Journal of the International Neuropsychological Society 6: 8699.
Chang, YL, Yang, CC, Deng, JF et al (1999) Diverse manifestations of oral methylene chloride poisoning: report of 6 cases. Journal of Toxicology-Clinical Toxicology 37: 497.
Choi, IS (1983) Delayed neurologic sequelae in carbon monoxide intoxication. Archives of Neurology 40: 433–5.
Choi, S (2000) Delayed neurological sequelae in carbon monoxide intoxication. Archives of Neurology 57: 1214–8.
Chu, K, Jung, KH, Kim, HJ et al (2004) Diffusion-weighted MRI and 99mTc-HMPAO SPECT in delayed relapsing type of carbon monoxide poisoning: evidence of delayed cytotoxic edema. European Neurology 51: 98.
Clardy, PF, Manaker, S, Perry, H et al (2010) Carbon monoxide poisoning. UpToDate (online journal: http://www.uptodate.com).
Cobb, N, Etzel, RA (1991) Unintentional carbon monoxide-related deaths in the United States, 1979 through 1988. Journal of the American Medical Association 266: 659–63.
Ernst, A, Zibrak, JD (1998) Carbon monoxide poisoning. New England Journal of Medicine 339: 1603.
Geehr, EC, Salluzzo, R, Bosco, S et al (1989) Emergency health impact of a severe storm. American Journal of Emergency Medicine 7: 598604.
Ginsberg, MD, Myers, RE, McDonagh, RF (1974) Experimental carbon monoxide encephalopathy in the primate: II. Clinical aspects, neuropathology, and physiologic correlation. Archive of Neurology 30: 209–16.
Goldbaum, LR, Ramirez, RG, Absalon, KB (1975) What is the mechanism of carbon monoxide toxicity? Aviation, Space, and Environmental Medicine 46: 1289.
Griffin, SM, Ward, MK, Terrell, AR et al (2008) Diesel fumes do kill: a case of fatal carbon monoxide poisoning directly attributed to diesel fuel exhaust with a 10-year retrospective case and literature review. American Academy of Forensic Sciences 53: 1206–11.
Hampson, NB, Dunford, RG, Kramer, CC et al (1995) Selection criteria utilized for hyperbaric oxygen treatment of carbon monoxide poisoning. Journal of Emergency Medicine 13: 227.
Hampson, NB (1999) Hyperbaric Oxygen Therapy: 1999 Committee Report. Undersea and Hyperbaric Medical Society.
Hopkins, RO, Woon, FLM (2006) Neuroimaging, cognitive, and neurobehavioural outcomes following carbon monoxide poisoning. Behavioural and Cognitive Neuroscience Reviews 5: 144–55.
Jones, JS, Lagasse, J, Zimmerman, G (1994) Computerized tomographic findings after acute carbon monoxide poisoning. American Journal of Emergency Medicine 12: 448–51.
Kao, LW, Nanagas, KA (2004) Carbon monoxide poisoning. Emergency Medicine Clinics of North America 22: 985.
Kim, JH, Chang, KH, Song, IC et al (2003) Delayed encephalopathy of acute carbon monoxide intoxication: diffusivity of cerebral white matter lesions. American Journal of Neuroradiology 24: 1592.
Koehler, RC, Jones, MD Jr, Traystman, RJ (1982) Cerebral circulatory response to carbon monoxide and hypoxic hypoxia in the lamb. American Journal of Physiology 243: 2732.
Lee, E, Leung, CM (2008) Clinical predictors of psychiatric and medical morbidities of charcoal-burning suicide attempt in Hong Kong. General Hospital Psychiatry 30: 561–3.
Liu, KY, Beautrais, A, Caine, E et al (2007) Charcoal burning suicides in Hong Kong and urban Taiwan: an illustration of the impact of a novel suicide method on overall regional rates. Journal of Epidemiology and Community Health 61: 248–53.
Lo, C-P, Chen, S-Y, Lee, K-W, et al (2007) Brain injury after acute carbon monoxide poisoning: early and late complications. Neuroradiology 189: W20511.
Mak, A, Ho, RCM, Lau, CS (2009) Clinical implications of neuropsychiatric systemic lupus erythematosus. Advances in Psychiatric Treatment 15: 451–8.
Mangaoang, MA, Lucey, JV (2007) Cognitive rehabilitation: assessment and treatment of persistent memory impairments following ECT. Advances in Psychiatric Treatment 13: 90100.
Mannaioni, PF, Vannacci, A, Masini, E (2006) Carbon monoxide: the bad and the good side of the coin, from neuronal death to anti-inflammatory activity. Inflammation Research 55: 261–73.
Mateer, CA, Sira, CS, O'Connell, ME (2005) Putting Humpty Dumpty together again: the importance of integrating cognitive and emotional interventions. Journal of Head Trauma and Rehabilitation 20: 6275.
Messier, LD, Myers, RA (1991) A neuropsychological screening battery for emergency assessment of carbon-monoxide-poisoned patients. Journal of Clinical Psychology 47: 675–84.
Mimura, K, Harada, M, Sumiyoshi, S et al (1999) Long-term follow-up study on sequelae of carbon monoxide poisoning: a serial investigation 33 years after poisoning. Seishin Shinkeigaku Zasshi 101: 592618.
Miura, T, Mitomo, M, Kawai, R et al (1985) CT of the brain in acute carbon monoxide intoxication: characteristic features and prognosis. American Journal of Neuroradiology 6: 739–42.
Pan, Y-J, Liao, S-C, Lee, M-B (2009) Suicide by charcoal burning in Taiwan, 1995–2006. Journal of Affective Disorders 120: 254–7.
Parkinson, RB, Hopkins, RO, Cleavinger, HB et al (2002) White matter hyperintensities and neuropsychological outcome following carbon monoxide poisoning. Neurology 58: 1525–32.
Piantadosi, CA, Zhang, J, Levin, ED et al (1997) Apoptosis and delayed neuronal damage after carbon monoxide poisoning in the rat. Experimental Neurology 147: 103–14.
Porter, SS, Hopkins, RO, Weaver, LK et al (2002) Corpus callosum atrophy and neuropsychological outcome following carbon monoxide poisoning. Archives of Clinical Neuropsychology 17: 195204.
Prockop, LD, Chichkova, RI (2007) Carbon monoxide intoxication: an updated review. Journal of Neurological Sciences 262: 122–30.
Sawada, Y, Takahashi, M, Ohashi, N et al (1980) Computerised tomography as an indication of long-term outcome after acute carbon monoxide poisoning. Lancet 1: 783–4.
Silver, DA, Cross, M, Fox, B et al (1996) Computerized tomography of the brain in acute carbon monoxide poisoning. Clinical Radiology 51: 480–3.
Sokal, JA, Kralkowska, E (1985) The relationship between exposure duration, carboxylhaemoglobin, blood glucose, pyruvate and lactate and the severity of intoxication in 39 cases of acute carbon monoxide poisoning in man. Achive of Toxicology 57: 196–9.
Song, SY, Okeda, R, Funata, N et al (1983) An experimental study of pathogenesis of the selective lesion of the globus pallidus in acute carbon monoxide poisoning in cats. Acta Neuropathologica 61: 232–8.
Starkey, W (1914) Carbon monoxide poisoning. Journal of Mental Science 60: 120.
Steele, GDF, Hegarty, AB (1950) Parieto-occipital syndrome following carbon monoxide poisoning. Journal of Mental Science 96: 1015–23.
Stoller, KP (2007) Hyperbaric oxygen and carbon monoxide poisoning: a critical review. Neurological Research 29: 146–55.
Teksam, M, Casey, SO, Michel, E et al (2002) Diffusion-weighted MR imaging findings in carbon monoxide poisoning. Neuroradiology 44: 109.
Tomaszewski, C (1999) Carbon monoxide poisoning. Early awareness and intervention can save lives. Postgraduate Medicine 105: 39.
Thom, SR (1990a) Antagonism of carbon monoxide mediated brain lipid peroxidation by hyperbaric oxygen. Toxicology and Applied Pharmacology 105: 340–4.
Thom, SR (1990b) Carbon monoxide-mediated brain lipid peroxidation in the rat. Journal of Applied Physiology 68: 997.
Thom, SR, Xu, YA, Ischiropoulos, H (1997) Vascular endothelial cells generate peroxynitrite in response to carbon monoxide exposure. Chemical Research in Toxicology 10: 1023.
Thom, SR, Bhopale, VM, Fisher, D et al (2004) Delayed neuropathy after carbon monoxide poisoning is immune-mediated. Proceedings of the National Academy of Sciences of the United States of America 101: 13660–5.
Tvedt, B, Kjuus, H (1997) Chronic CO poisoning. Use of generator gas during the Second World War and recent research. Tidsskr Nor Laegoforen 117: 2454–7.
Uchino, A, Hasuo, K, Shida, K et al (1994) MRI of the brain in chronic carbon monoxide poisoning. Neuroradiology 36: 399401.
Wang, P, Zeng, T, Chi, Z-F (2009) Recovery of cognitive dysfunction in a case of delayed encephalopathy of carbon monoxide poisoning after treatment with donepezil hydrochloride. Neurology India 57: 481–2.
Watanabe, N, Nohara, S, Matsuda, H et al (2002) Statistical parametric mapping in brain single photon computed emission topography after carbon monoxide intoxication. Nuclear Medicine Communications 23: 355–66.
Weaver, LK (1999) Carbon monoxide poisoning. Critical Care Clinics 15: 297317.
Weaver, LK, Valentine, KJ, Hopkins, RO (2007) Carbon monoxide poisoning: risk factors for cognitive sequelae and the role of hyperbaric oxygen. American Journal of Respiratory and Critical Care Medicine 176: 491–7.
Zhang, J, Piantadosi, CA (1992) Mitochondrial oxidative stress after carbon monoxide hypoxia in the rat brain. Journal of Clinical Investigation 90: 1193.
Zagami, AS, Lethlean, AK, Mellick, R (1993) Delayed neurological deterioration following carbon monoxide poisoning: MRI findings. Journal of Neurology 240: 113.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
  • URL: /core/journals/bjpsych-advances
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Neuropsychiatric aspects of carbon monoxide poisoning: diagnosis and management

  • Roger Chun Man Ho, Wendy Cheng, Anna Nyap Cheng Chua and Anselm Mak
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *