Gas Geyser Encephalopathy

Dr Bipin Bhimani DM ( Neuro)

Well care Hospital Rajkot

Case

•A young lady•30 yrs old•Found out unconscious in bath room•Suspicious tongue bite ( at tip)•Slowly recovered with slowness of gait and cognitive problems in earlier stage

•No past history of any significance

Vitals- normal Neurologically –HMF –abnormal

(subcortical dementia ) CBC/biochemistry-normal CT scan brain- normal MR brain- bilateral basal ganglionic

changes

MR brain:

Gas gayser encephalopathy Winter season Small bathroom Ill ventilated/ closed windows Poor manufacturing ( substandard brand) Female (taking longer time in bathroom )

Tandem bathing pattern ( one after

another family members going for bath

Pathophysiology: ( toxic gases)

LPG ---butane/propane CO2 CO Nitrous oxides Hydrocarbon gases ( HC)

Reoxygenation injuries

Largest series reported in Pune, 48 cases (Dr R Kulkarni)

Most patient had normal MR brain One had cortical blindness with DW

changes in bilateral occipital lobes

Treatment:

Prevention is best Remove patient Hyperbaric oxygen ( ? Reperfusion

injury)

Other DDs of “found unconscious”:

Seizure/SE SAH/other strokes Cardiac event Trauma Poisioning Hypoglycemia

“Angithees” in Kashmir region /hot stove

Clinical importance:

exact diagnosis avoids multiple investigations

Avoids prolonged &unnecessary AEDs

A highly preventable situation

Thank You