Definition of delayed-onset neurologic sequelae: A scoping review
Definition of delayed-onset neurologic sequelae: A review article
Alik Dakessian, MD1,2, Zachary Hagen, MD1, Eugenio R Rocksmith, MD3, Kinjal N Sethuraman, MD, MPH1,2,*
1Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States of America
2Hyperbaric and Dive Medicine, University of Maryland Medical Center, Baltimore, MD, United States of America
3Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States of America
Background: Delayed-onset neurologic sequelae (DNS) is a devastating complication of carbon monoxide poisoning. Despite the abundance of research studies on DNS, the definition remains unclear, with a wide range of symptoms. The aim of this review is to identify the different symptoms and definitions that have been associated with DNS in available research.
Methods: For this review, searches were conducted in both PubMed and Scopus. Research studies were screened by abstract and title by two authors and conflicts were resolved by a third. After the full-text review, data was extracted by one author. Only original full-text research studies in English with a clear definition of DNS were included.
Results: A total of 127 studies were included in this review. Signs and symptoms associated with DNS were categorized into twelve groups. The most commonly used symptom categories to define DNS were general neurological and cognitive/learning dysfunctions. Imaging studies, clinical testing, and neuropsychiatric testing used to define DNS were also documented.
Conclusions: There was no consistent definition for DNS attributed to CO toxicity in the literature. Clinical research would benefit from standardizing the definition and diagnostic criteria.