OXY-HELIUM TREATMENT FOR REFRACTORY NEUROLOGICAL DECOMPRESSION-SICKNESS - A CASE-REPORT

A 49-yr-old male presented with paraparesis and urinary incontinence t hat appeared 10 min after surfacing from a dive. Treatment was started on an extended USN table 6, but the symptoms persisted. Twenty-four h ours later, he was treated with oxy-helium table CX-30, resulting in m arked improvement in gait and in sensory and motor function. Urodynami c examination indicated an upper motor neuron lesion; bilateral decrea sed amplitude of the somatosensory evoked potential was found on stimu lation of the tibial nerves; no response below the upper limbs was eli cited on central motor conduction time (CMCT) testing; MRI showed lesi ons in the lower dorsal cord. The patient's condition was further impr oved by an additional 10 hyperbaric oxygenation sessions, with complet e restoration of urinary control and virtually complete sensory and mo tor recovery. Follow-up urodynamic studies were normal. CMCT recording s showed a bilateral lower limb small-amplitude response. The present case reinforces the limited clinical data regarding the value of oxy-h elium in the treatment of neurological decompression sickness, even wh en primary treatment with oxygen tables is unsuccessful.