[abstract] A CASE OF RECURRING NEUROLOGIC DECOMPRESSION ILLNESS: OR IS IT?

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[abstract] A CASE OF RECURRING NEUROLOGIC DECOMPRESSION ILLNESS: OR IS IT?

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Title: [abstract] A CASE OF RECURRING NEUROLOGIC DECOMPRESSION ILLNESS: OR IS IT?
Author: Worth, ER; Patel, N; Freiberger, JJ
Abstract: CASE REPORT: A 12 year-old female with a past medical history of asthma, idiopathic urticaria and edema, irritable bowel syndrome, multiple environmental allergies, sinusitis and headache complained of exhaustion, hives, a painful swollen foot and inability to bear weight with her left leg 18 hours after making two uneventful warm water, 60 fsw, non-decompression dives. She had been diving for the previous 2 days without problems. On day 2 after the dive, foot pain, weakness and exhaustion continued and medical evaluation was obtained. A diagnosis of neurological decompression sickness was made and she received a USN Treatment Table 6 without improvement. On day 3 exhaustion persisted, weakness improved, and a new symptom, chest pain, developed. She continued to be treated for DCS receiving 3 successive days of 3.5 hour, 2 ATA treatments with little success. In spite of treatment, her symptoms continued to wax and wane with eventual resolution. Seven days after her last treatment she returned home by air. Six hours after the flight she had a recurrence of exhaustion with left leg and arm weakness. Again her symptoms waxed and waned, improving to the point of allowing her to attend her scheduled dance class, however, 24 hours after returning home she fell down the stairs due to weakness and was brought to the University of Missouri Hospital for evaluation. Significant findings on physical examination included 4/5 muscle strength in the left leg, which rapidly resolved. The DAN hotline was consulted. Because the history was highly atypical for DCI, a search for another cause for her symptoms was suggested. A pediatric neurologist was consulted who ordered EEG and CT scans which were normal, however immediately prior to discharge, she developed identical symptoms, now associated with a headache. On further workup she was found to have complicated migraine headaches with neurological deficits. CONCLUSION: A careful history and physical examination are critical to making any diagnosis. Not all symptoms after diving are diving related. Prior to making a diagnosis of DCI complete past medical history including medications and previous hospitalizations should be considered. Patients with late onset, vague or recurring symptoms should always be carefully followed to rule out other causes before attributing their symptoms to DCI.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/1685
Date: 2005

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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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