| 일산화탄소 중독후의 지연성 운동장애 |
| 천화영, 김승민 ·최일생 |
| 연세대학교 의과대학 신경과학교실 |
| Delayed-onset Movement Disorders after Carbon Monoxide Intoxication |
| Hwa-Young Cheon, M.D., Seung Min Kim, M.D., Il Saing Choi, M.D. |
| Department of Neurology, Yonsei University Medical College |
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| Abstract |
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Background : Presently, it is well known that there are neurological and systemic complications after carbon monox-ide (CO) intoxication. Until recently, delayed-onset movement disorders after CO intoxication were rarely reported. We analyzed 32 patients with delayed onset movement disorders after CO intoxication. Methods : We reviewed the medical records of 242 patients admitted to the Yonsei University Medical Center from January 1986 to December 1996 due to CO intoxication. Patients were analyzed with respect to movement disorders, onset, latency, and radiological findings. Results : Among the 242 patients of CO intoxication, 32 (13.2%) patients had delayed-onset movement disorders. Of these, 23 (71.9%) had parkinsonism, 5 (15.6%) had dystonia, 3 (9.4%) had chorea, and 1 (3.1%) had myoclonus. The mean age of the patients was 46.66 ±16.91 years. Among the 4 patients with CO intoxication occuring at age 17 or younger (Childhood group), 2 had parkinsonism and 2 had focal dystonia. The mean age of the Childhood group was 1 7 . 7 5 ±6.99 years. Among the 28 patients with CO intoxication occuring at age 18 or older (Adult group), 21 (75%) had parkinsonism, 3(10.7%) dystonia, 3(10.7%) chorea, and 1(3.6%) myoclonus. Among the 3 patients with dystonia in the Adult group, 1 had focal dystonia and 2 had segmental dystonia. The mean age of the adult group was 50.79 ±1 3 . 4 6 years. The mean latency between CO intoxication and the onset of movement disorders was 27.20 ±27.94 weeks in the Childhood group and 9.60 ±14.97 weeks in the Adult group. The mean latency between CO intoxication and the onset of movement disorders was 6.44 ±6.76 weeks in parkinsonism, 41.76 ±27.99 weeks in dystonia, 4.0 weeks in chorea, and 8.0 weeks in myoclonus. The mean latency in dystonia was longer than in the others. Among the 23 patients who underwent brain computed tomography, 12 (52.2%) had abnormal findings. Low density lesions were found in the globus pallidus (13.0%), cerebral white matter (13.0%), and both globus pallidus and cerebral white matter (17.4%). One (14.3%) patient showed cortical atrophy while another patient showed both cortical atrophy and low density in cerebral white matter. Conclusions : The development of a delayed-onset movement disorder after CO intoxication is not rare. In our research, the radiological findings of patients with delayed-onset movement disorders after CO intoxication were inconsistant. The findings revealed no correlations with the various types of delayed-onset movement disorders.
J Kor Neurol Ass 17 (4):514~519, 1999
Key Words : Carbon Monoxide Intoxication, Delayed-Onset, Movement Disorder |
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