Delayed Encephalopathy after Carbon Monoxide Poisoning Improved by High Dose Prednisolone

Background: Delayed encephalopathy after carbon monoxide (CO) poisoning is a severe neurologic impairment that occurs after apparent recovery from the acute event. These patients rarely remain neurologically independent, and no effective treatment has yet been validated. Case Report: Two patients had survived acute CO intoxication without neurologic sequelae. Three weeks after each of the two patients recovered, the patients gradually developed cognitive impairment, urinary incontinence, akinetic mutism and parkinsonism. After the administration of high dose prednisolone, the treatment response was prompt within two weeks, and the patients have recovered with mild cognitive impairment within one year. Conclusion: High dose prednisolone can be used for treatment of delayed encephalopathy after CO poisoning.