Abstract Details

Title Clinical Classification of Delayed Encephalopathy after Carbon Monoxide Poisoning and Utility of Myelin Basic Protein in Cerebrospinal Fluid

Topic Critical Care/Emergency Neurology/Trauma

Presentation(s) S07 - (-)

Poster/Presentation
Number 002

Background The outcomes of DE, characterized by relapsed neurological deficits, are wide-ranging. However, no classifications focusing on outcome have been established. MBP in cerebrospinal fluid (CSF) has been utilized to quantify demyelination, however, the predictive value of CSF-MBP for DE has not been fully evaluated.

Objective

Design/Methods This study was designed as a cohort study. We defined the clinical classification and the severity scale (SS) of DE; analyzed the relationship between the SS scores and the clinical parameters. We measured CSF-MBP concentrations both at the acute and the recovery phase; compared the CSF-MBP levels in DE group with those in non-DE group; analyzed the relationship between the CSF-MBP levels and the SS scores.

Results Of 78 patients with acute CO poisoning, 16 patients (21%) developed DE and 62 patients (79%) did not. We identified three patterns in the clinical courses of DE. First (SS1), patients showed mild neurological deficits but kept independent (n=4, 25%); second (SS2), patients showed moderate deficits at the nadir of DE, but became independent eventually (n=8, 50%); third (SS3), patients showed severe deficits permanently after DE onset (n=4, 25%). The SS scores correlated with the ages (r=0.8449, p<0.0001) and negatively correlated with the DE onset days (r=-0.8654, p<0.0001). The CSF-MBP levels were higher in DE group than those in non-DE group both at the acute phase and the recovery phase (p<0.001). The CSF-MBP levels at the recovery phase moderately correlated with the SS scores (r=0.5494, p=0.0339).

Conclusions Clinical classification of DE may be useful for evaluating the severity of DE; measuring CSF-MBP concentrations may be useful for predicting the outcome of DE as well as predicting the risk of developing DE.

Authors/Disclosures
PRESENTER	No disclosure on file
Kazuo Fujihara, MD (Tohoku University, School of Medicine)	Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck Boipharma. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Japan Tobacco. Dr. Fujihara has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Fujihara has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Mitsubishi-Tanabe. Dr. Fujihara has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Chugai/Roche. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Fujihara has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. Dr. Fujihara has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. The institution of Dr. Fujihara has received research support from Ministry of Health, Welfare and Labor of Japan. Dr. Fujihara has received personal compensation in the range of $10,000-$49,999 for serving as a speaker, chair, etc with Novartis. Dr. Fujihara has received personal compensation in the range of $5,000-$9,999 for serving as a speaker, chair, etc with Biogen. Dr. Fujihara has received personal compensation in the range of $10,000-$49,999 for serving as a speaker, chair, etc with Mitsubishi-Tanabe. Dr. Fujihara has received personal compensation in the range of $10,000-$49,999 for serving as a apeaker, chair, etc with Chugai/Roche. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving as a speaker, chair, etc with Alexion. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving as a chair, speaker with Asahi Kasei Medical. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving as a speaker with Eisai. Dr. Fujihara has received personal compensation in the range of $500-$4,999 for serving as a speaker, chair with Teijin.
	No disclosure on file
	No disclosure on file
Masashi Aoki, MD, PhD (Day Neuromuscular Research Laboratory)	Masashi Aoki, MD, PhD has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Tanabe Mitsubishi.
	No disclosure on file

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