Acupuncture for the treatment of Delayed Encephalopathy after Acute Carbon Monoxide Poisoning: a case report

Background: Delayed Encephalopathy after Acute Carbon Monoxide Poisoning (DEACMP) is characterized by delayed neuropsychiatric deterioration after a period of apparent recovery. Effective treatments remain limited. Case presentation: A 75-year-old male developed cognitive decline, motor dysfunction, incontinence, and sleep disturbance persisting for more than 3 months after carbon monoxide poisoning despite standard therapy. MRI showed diffuse white matter demyelination. Intervention and outcomes: Zhu's scalp acupuncture combined with body acupuncture was administered once daily for 15 sessions. Baseline MMSE and AD8 were not testable due to severe disorganized speech and poor cooperation. After treatment initiation, MMSE improved from 11 (after 1 session) to 14 (after 3 sessions), 24 (after 15 sessions), and 26 at one-month follow-up. AD8 decreased from 7 to 5, 2, and 1 at the corresponding time points. Functional independence was restored. No adverse events were reported. Conclusion: The temporal pattern of improvement suggests a possible association between acupuncture intervention and neurological recovery. Controlled studies are needed to further evaluate efficacy.