Delayed Neurological Sequelae in an Infant after Carbon Monoxide Intoxication

Delayed neurological sequelae are symptoms that appear over a period of time after an acute event of carbon monoxide poisoning. The incidence of delayed neurological sequelae is lower in children than in adults and is even more uncommon in infants. Here, we present a case of a 4-month-old infant who developed delayed neurological sequelae after carbon monoxide intoxication. She presented with neurologic symptoms, including opisthotonus, athetoid movements, anterior tongue thrust, and opsoclonus. Because these symptoms are starkly different from those of adults, they should be compared with age-appropriate developmental milestones. Because of their faster metabolic rate and presence of fetal hemoglobin, infants with developing brains may be especially vulnerable to carbon monoxide toxicity. Therefore, thorough neurologic examination and prompt treatment are critical for infants who experience carbon monoxide intoxication.

The History of Carbon Monoxide Intoxication

Intoxication with carbon monoxide in organisms needing oxygen has probably existed on Earth as long as fire and its smoke. What was observed in antiquity and the Middle Ages, and usually ended fatally, was first successfully treated in the last century. Since then, diagnostics and treatments have undergone exciting developments, in particular specific treatments such as hyperbaric oxygen therapy. In this review, different historic aspects of the etiology, diagnosis and treatment of carbon monoxide intoxication are described and discussed.