PERSISTENT COGNITIVE AND MOTOR DEFICITS FOLLOWING ACUTE HYDROGEN-SULFIDE POISONING

This case study describes the long-term after-effects of hydrogen sulp hide exposure in a previously healthy 27-year-old male. Upon hospital admission the patient had a Glasgow Coma Score (CGS) of 3; with emerge ncy treatment including hyperbaric oxygen treatments, he progressed to a GCS of 15 on day 7. Although both CT and MRI scans were unremarkabl e, PET using F-18 deoxyglucose administered 3 years after the accident showed abnormally decreased metabolism bilaterally in the temporal an d inferior parietal lobes as well as the left thalamus. Uptake in the striatum was heterogeneous and abnormal. A cerebral perfusion study us ing SPECT performed 3.5 years after the accident revealed bilaterally decreased flow in the putamen but no cortical abnormalities. Neuropsyc hological and neurofunctional testing revealed the following impairmen ts: microsmia, psychomotor slowing, extrapyramidal signs and deficits in memory and executive/planning functioning. These findings are discu ssed in the context of hydrogen sulphide's known mechanisms of toxicit y and the functions of the basal ganglia.