Document Detail


The syndrome of delayed post-hypoxic leukoencephalopathy.
MedLine Citation:
PMID:  20166270     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Delayed post-hypoxic leukoencephalopathy (DPHL) is a demyelinating syndrome characterized by acute onset of neuropsychiatric symptoms days to weeks following apparent recovery from coma after a period of prolonged cerebral hypo-oxygenation. It is diagnosed, after excluding other potential causes of delirium, with a clinical history of carbon monoxide poisoning, narcotic overdose, myocardial infarction, or another global cerebral hypoxic event. The diagnosis can be supported by neuroimaging evidence of diffuse hemispheric demyelination sparing cerebellar and brainstem tracts, or by an elevated cerebrospinal fluid myelin basic protein. Standard or hyperbaric oxygen following CO poisoning may reduce the likelihood of DPHL or other neurologic sequelae. Bed rest and avoidance of stressful procedures for the first 10 days following any prolonged hypoxic event may also lower the risk. Gradual recovery over a 3 to 12 month period is common, but impaired attention or executive function, parkinsonism, or corticospinal tract signs can persist. Stimulants, amantadine or levodopa may be considered for lasting cognitive or parkinsonian symptoms. Anticipation and recognition of DPHL should lead to earlier and more appropriate utilization of health care services.
Authors:
David Shprecher; Lahar Mehta
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  NeuroRehabilitation     Volume:  26     ISSN:  1878-6448     ISO Abbreviation:  NeuroRehabilitation     Publication Date:  2010  
Date Detail:
Created Date:  2010-02-18     Completed Date:  2010-04-26     Revised Date:  2010-12-30    
Medline Journal Info:
Nlm Unique ID:  9113791     Medline TA:  NeuroRehabilitation     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  65-72     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Utah, Salt Lake City, UT 84108, USA. David.Shprecher@hsc.utah.edu
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MeSH Terms
Descriptor/Qualifier:
Anoxia / complications*,  diagnosis,  epidemiology
Cognition Disorders / etiology,  therapy
Diagnosis, Differential
Disease Progression
Humans
Leukoencephalopathies / diagnosis,  epidemiology,  etiology*,  therapy
Grant Support
ID/Acronym/Agency:
L30 NS063416-01/NS/NINDS NIH HHS
Comments/Corrections

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