PMID- 34157731
OWN - NLM
STAT- MEDLINE
DCOM- 20210624
LR  - 20220716
IS  - 1833-3516 (Print)
IS  - 2209-1491 (Electronic)
IS  - 1833-3516 (Linking)
VI  - 51
IP  - 2
DP  - 2021 Jun 30
TI  - Oxygen toxicity seizure mimics.
PG  - 161-166
LID - 10.28920/dhm51.2.161-166 [doi]
AB  - INTRODUCTION: Oxygen toxicity seizures (OTS) are a well-recognised complication 
      of hyperbaric oxygen treatment (HBOT). As such, seizure-like activity during HBOT 
      is usually presumed to be a result of central nervous system oxygen toxicity 
      (CNS-OT). Four cases are reported here where causes other than CNS-OT were 
      determined as being the likely cause of the seizure; causes we have labelled 'OTS 
      mimics'. Through review of the current literature, and our hyperbaric medicine 
      unit's experience to date, we aimed to highlight the relevance of these OTS 
      mimics, as the potential for significant morbidity and mortality exists with 
      incorrect diagnoses. METHODS: A retrospective review of the medical records of 
      all patients treated at the Fiona Stanley Hospital and Fremantle Hospital 
      hyperbaric medicine units who had a seizure during HBOT between November 1989 and 
      June 2020. These events were reviewed to determine whether causes for seizures 
      other than oxygen toxicity were evident. RESULTS: Four OTS mimics were 
      identified: posterior reversible encephalopathy syndrome, pethidine toxicity, 
      previous subarachnoid haemorrhage with resultant epilepsy, and severe 
      hypoglycaemia. CONCLUSIONS: This case series highlights the need for caution when 
      diagnosing an apparent OTS. Multiple conditions may mimic the signs and symptoms 
      of oxygen toxicity. This creates scope for misdiagnosis, with potential for 
      consequent morbidity and mortality. A pragmatic approach is necessary to any 
      patient exhibiting seizure-like activity during HBOT, with suspicion for other 
      underlying pathologies.
CI  - Copyright: This article is the copyright of the authors who grant Diving and 
      Hyperbaric Medicine a non-exclusive licence to publish the article in electronic 
      and other forms.
FAU - Foley, Kevin
AU  - Foley K
AD  - Department of Hyperbaric Medicine, Fiona Stanley Hospital, Perth, Australia.
FAU - Banham, Neil
AU  - Banham N
AD  - Department of Hyperbaric Medicine, Fiona Stanley Hospital, Perth, Australia.
AD  - Corresponding author: Dr Neil Banham, Department of Hyperbaric Medicine, Fiona 
      Stanley Hospital, 11 Robin Warren Drive, Murdoch WA 6150, Australia, 
      neil.banham@health.wa.gov.au.
FAU - Bonnington, Samantha
AU  - Bonnington S
AD  - Department of Hyperbaric Medicine, Fiona Stanley Hospital, Perth, Australia.
FAU - Gawthrope, Ian
AU  - Gawthrope I
AD  - Department of Hyperbaric Medicine, Fiona Stanley Hospital, Perth, Australia.
LA  - eng
PT  - Journal Article
PL  - Australia
TA  - Diving Hyperb Med
JT  - Diving and hyperbaric medicine
JID - 101282742
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Humans
MH  - *Hyperbaric Oxygenation
MH  - Oxygen
MH  - *Posterior Leukoencephalopathy Syndrome
MH  - Retrospective Studies
MH  - Seizures/chemically induced/diagnosis
PMC - PMC8426116
OTO - NOTNLM
OT  - Brain
OT  - Clinical audit
OT  - Hyperbaric oxygen treatment
OT  - Hyperbaric research
OT  - Neurology
OT  - Recompression
OT  - Risk factors
COIS- Conflict of interest and funding: nil
EDAT- 2021/06/23 06:00
MHDA- 2021/06/25 06:00
PMCR- 2022/06/30
CRDT- 2021/06/22 20:27
PHST- 2020/10/07 00:00 [received]
PHST- 2021/02/02 00:00 [accepted]
PHST- 2021/06/22 20:27 [entrez]
PHST- 2021/06/23 06:00 [pubmed]
PHST- 2021/06/25 06:00 [medline]
PHST- 2022/06/30 00:00 [pmc-release]
AID - 10.28920/dhm51.2.161-166 [doi]
PST - ppublish
SO  - Diving Hyperb Med. 2021 Jun 30;51(2):161-166. doi: 10.28920/dhm51.2.161-166.