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A Case Report Of A Rare, But Important, Cause Of Delerium Presenting To An Emergency Department
Journal article   Open access   Peer reviewed

A Case Report Of A Rare, But Important, Cause Of Delerium Presenting To An Emergency Department

Daniel G Miller
Clinical Practice and Cases in Emergency Medicine, Vol.9(2), pp.178-181
05/2025
DOI: 10.5811/CPCEM.31059
PMCID: PMC12097256
PMID: 40402060
url
https://doi.org/10.5811/CPCEM.31059View
Published (Version of record) Open Access

Abstract

Introduction: Delayed post-hypoxic leukencephalopathy (DPHL) is a rare cause of acute neuropsychiatric decline diagnosable in Emergency Departments, but it has not been described in the Emergency Medical literature. We present a case report of a pathognomonic presentation. Case Report: A man developed akinetic mutism fourteen days after being discharged from a hospitalization for fentanyl overdose. His presentation and MRI were pathognomonic for DPHL. Conclusion: DPHL can present to the ED as altered mental status days to weeks after apparent full recovery from an initial episode of cerebral hypoxia. This report will help Emergency Providers avoid missing this diagnosis.
case report Delayed post-hypoxic leukencephalopathy delirium causes emergency neurology

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