[abstract] DECOMPRESSION ILLNESS PRESENTING AS ACUTE PSYCHOSIS

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[abstract] DECOMPRESSION ILLNESS PRESENTING AS ACUTE PSYCHOSIS

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Title: [abstract] DECOMPRESSION ILLNESS PRESENTING AS ACUTE PSYCHOSIS
Author: Glover, NR; Van Meter, KW; LeGros, TL; Barratt, DM
Abstract: INTRODUCTION: Acute psychosis has been described in the literature as a decompression illness; however, it is exceedingly rare due to the mechanisms involved or the failure of clinicians to diagnose. CASE REPORT: In April 2003, a previously healthy 31-year-old male recreational scuba diver presented to the emergency department with agitation, delusions, paranoia, and complex visual hallucinations two days following a sport dive. Acute delirium work up was negative with the exception of an abnormal computed tomography scan of the brain, which revealed a questionable hypodensity in the pons region. Emergent magnetic resonance imaging followed, conveying possible abnormalities in bilateral cerebral peduncles on T2 and diffusion weighted images. Comprehensive history taking disclosed a breath holding ascent from forty-five feet to fifteen feet for retrieval of a lost camera. The hyperbaric medicine team was consulted for presumed decompression illness. The patient was treated with a United States Navy Treatment Table six dive protocol with significant abatement of his symptoms. Improvement continued with trailing treatments until the patient achieved his baseline mental status. Somatosensory evoked potentials later confirmed bilateral cerebral peduncular lesions. Subsequent brain imaging by single photon emission computed tomography scanning revealed improved blood flow to the compromised areas indicated on the previous magnetic resonance imaging study. The patient's psychosis resolved following multiple hyperbaric oxygen treatments without complication, and the patient was able to return to his previous employment as a computer programmer with minimal difficulty. CONCLUSION: Any diver with any alteration of neurologic status including diffuse global deterioration and psychosis should be treated as decompression illness with hyperbaric oxygen therapy as the standard of care.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/1482
Date: 2004

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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