Introduction to the treatment methods of delayed encephalopathy

Delayed encephalopathy actually refers to a neurological abnormality that occurs in patients with carbon monoxide poisoning several days after rescue and recovery, such as dementia or brain dysfunction. It must be treated correctly using some hormone drugs.

1. Delayed encephalopathy after acute carbon monoxide poisoning (DEACMP ) refers to a group of neuropsychiatric symptoms, mainly acute dementia, in which patients with carbon monoxide poisoning appear normal or nearly normal after a "false recovery period" of several days or weeks after the acute poisoning symptoms are recovered after rescue. Or some patients with acute carbon monoxide poisoning may suddenly develop brain dysfunction characterized by dementia, mental illness and extrapyramidal symptoms after their consciousness disorders return to normal during the acute phase and after a period of false recovery. It usually occurs within two months after acute poisoning.

2. Acute treatment

(1) Hyperbaric oxygen therapy should last for more than 3 months or until the patient wakes up.

(2) Hormone application: generally dexamethasone, 10 mg/d intravenous drip for more than 1 month.

(3) The use of drugs to promote brain cell function recovery is the same as that for acute poisoning

(4) Delayed encephalopathy is often accompanied by increased muscle tension. In this case, the muscle relaxant eperisone (eperisone hydrochloride) can be added as the drug of choice. 50-100 mg, 2-3 times/d. Those with tremor can try using benzhexol (Antan) 2-4 mg 3 times/d. You can also use levodopa/benserazide (Madopa) (250 mg per tablet) starting with 1/4 tablet in the morning, 1/2 tablet in the afternoon, and 1/4 tablet in the evening, and then gradually increase to the therapeutic dose to improve symptoms.

(5) For patients in a long-term coma, pay attention to nutrition and provide nasogastric feeding. Pay attention to turning over and passive limb exercises to prevent bedsores and limb contracture deformities.

3. Rehabilitation treatment

It is currently believed that patients with limb movement disorders (muscle atrophy, fasciculations, spasms, etc.) caused by delayed encephalopathy can significantly reduce or alleviate sequelae through formal rehabilitation training. Some people regard rehabilitation as particularly simple, or even equate it with "exercise", and are eager for quick results, which often results in half the effort and twice the results, and leads to joint and muscle injuries, fractures, shoulder and hip pain, increased spasms, abnormal spasm patterns and abnormal gait, as well as foot drop, inversion and other problems, namely "misuse syndrome".