Abstract
Custodio CM, Basford JR. Delayed post-anoxic encephalopathy: a case report and literature
review. Arch Phys Med Rehabil 2004;85:502–5.
Delayed postanoxic encephalopathy is a rare condition in which patients appear to
make a complete clinical recovery after an episode of anoxia or hypoxia but then develop
a relapse characterized by apathy, confusion, agitation, and/or progressive neurologic
deficits. The incidence of delayed postanoxic encephalopathy is unclear but has been
reported to range from less than 1 to 28 per 1000 in patients who have suffered hypoxic
or anoxic events. The exact pathogenesis remains unknown. We describe a case of an
independently living 51-year-old woman admitted to an inpatient rehabilitation unit
11 days after a respiratory arrest. At admission, she exhibited cognitive and visual
deficits that were relatively mild but prevented a safe return to independent living.
Two days later, she developed the sudden onset and rapid worsening of parkinsonian
symptoms and excruciating bilateral lower-extremity pain. The pain was intractable,
and over the next 2 days she progressed to being unable to walk or perform her activities
of daily living without maximum assistance. A diagnosis of delayed postanoxic encephalopathy
was made, and the patient responded to a trial of carbidopa and levodopa as well as
redirection of her physical and occupational therapy programs. This case illustrates
the unusual presentation of delayed postanoxic encephalopathy during inpatient rehabilitation
and suggests that this condition should be considered if patients who have suffered
an anoxic or hypoxic event show a sudden neurologic deterioration.
Keywords
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Article info
Footnotes
☆No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
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Copyright
© 2004 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
