Objective: To highlight the presentation of parkinsonism caused by acute and chronic exposure to carbon monoxide(CO).

Background: Toxin-induced parkinsonism is not uncommon. One of the many toxins that are linked to the development of neurological complications is carbon monoxide. It can lead to different neurological sequelae at different degrees and stages of exposure, there have been some reports indicating that it can also cause damage to the liver, leading to abnormal liver function tests and focal hepatocyte necrosis resulting in chronic liver disease; which is also known to cause parkinsonism through the deposition of manganese in the basal ganglia.

Methods: We report two patients with Parkinsonism secondary to acute and chronic carbon monoxide exposure.

Results: Both patients reported insidious onset of parkinsonism following acute or chronic exposure to carbon monoxide. The second patient was also diagnosed with chronic liver disease.

Conclusions: Carbon monoxide can lead to acute and chronic neurologic sequelae, Parkinsonism is a delayed neurological complication. The pathophysiology of CO-induced parkinsonism may be caused by tissue anoxia and direct CO toxicity to the substantia nigra and globus pallidus. Brain MRI findings show diffuse white matter hyper- intensities and hemorrhagic necrosis of the pallidum.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/toxin-induced-parkinsonism-a-report-of-two-patients/