Liu CC, Hsu CS, He HC, Cheng YY, Chang ST. Effects of intravascular laser phototherapy on delayed neurological sequelae after carbon monoxide intoxication as evaluated by brain perfusion imaging: A case report and review of the literature. World J Clin Cases 2021; 9(13): 3048-3055 [PMID: 33969090 DOI: 10.12998/wjcc.v9.i13.3048]
Corresponding Author of This Article
Shin-Tsu Chang, MD, MS, PhD, Ex-Director, Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Blvd., Xitun District, Taichung 407, Taiwan. ccdivlaser1959@gmail.com
Research Domain of This Article
Integrative & Complementary Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 6, 2021; 9(13): 3048-3055 Published online May 6, 2021. doi: 10.12998/wjcc.v9.i13.3048
Effects of intravascular laser phototherapy on delayed neurological sequelae after carbon monoxide intoxication as evaluated by brain perfusion imaging: A case report and review of the literature
Chuan-Ching Liu, Chun-Sheng Hsu, Hsin-Chen He, Yuan-Yang Cheng, Shin-Tsu Chang, Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung 407, Taiwan
Chun-Sheng Hsu, Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung 402, Taiwan
Chun-Sheng Hsu, Department of Rehabilitation Science, Jenteh Junior College of Medicine, Nursing and Management, Miaoli 356, Taiwan
Yuan-Yang Cheng, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
Yuan-Yang Cheng, Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung 407, Taiwan
Shin-Tsu Chang, Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan
Author contributions: Liu CC reviewed the literature and drafted the manuscript; Hsu CS interpreted the imaging findings and drafted the manuscript; He HC reviewed the literature and helped design the figures; Cheng YY reviewed the literature and helped with the manuscript revision; Chang ST helped with the manuscript revision and provided important intellectual content. All authors granted approval for the final submitted version.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images. Ethics committee approval was given by the Research Committee of Taichung Veterans General Hospital (Document number: CE20065A).
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shin-Tsu Chang, MD, MS, PhD, Ex-Director, Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Blvd., Xitun District, Taichung 407, Taiwan. ccdivlaser1959@gmail.com
Received: September 16, 2020 Peer-review started: September 16, 2020 First decision: December 14, 2020 Revised: December 21, 2020 Accepted: December 28, 2020 Article in press: December 28, 2020 Published online: May 6, 2021 Processing time: 217 Days and 19.7 Hours
Abstract
BACKGROUND
Delayed neurological sequelae (DNS) caused by carbon monoxide (CO) intoxication poses considerable treatment challenges for clinical practitioners. In this report, we used nuclear medicine imaging and the Mini-Mental State Examination (MMSE) to evaluate the effectiveness of intravascular laser irradiation of blood (ILIB) therapy for the management of DNS.
CASE SUMMARY
A 51-year-old woman presented to our medical center experiencing progressive bradykinesia, rigidity of limbs, gait disturbance, and cognitive impairment. Based on her neurological deficits, laboratory tests and imaging findings, the patient was diagnosed with delayed neurological sequelae of CO intoxication. She received intensive rehabilitation and ILIB therapy during 30 sessions over 2 mo after diagnosis. Brain single-photon emission computed tomography was performed both prior to and after ILIB therapy. The original hypoperfusion area in bilateral striata, bilateral frontal lobe, right parietal lobe, and bilateral cerebellum showed considerable improvement after completion of therapy. The patient’s MMSE score also increased markedly from 6/30 to 25/30. Symptoms of DNS became barely detectable, and the woman was able to carry out her daily living activities independently.
CONCLUSION
ILIB therapy could facilitate recovery from delayed neurological sequelae in patients with CO intoxication, as demonstrated by improved cerebral blood flow and functional outcomes in our patient.
Core Tip: Carbon monoxide poisoning and its associated delayed neurological sequelae remain therapeutic difficulties for physicians. We present a patient who recovered after intravascular laser irradiation of blood, as evaluated by brain single-photon emission computed tomography images and the Mini-Mental State Examination. We report this case with the aim of triggering further research, and to facilitate the recovery of patients experiencing delayed neurological sequelae.
