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Neurologic Problems & Diving
 
 
Neurological Fitness To Dive
CNS Considerations in Scuba Diving
 DAN's Alert Diver, May-June1999
Epilepsy and Diving
Guillain-Barre Syndrome
Headaches and Diving
Herniated disc disease
Hydrocephalus and shunt
Multiple Sclerosis and Diving
Parkinson's Disease
Migraine Headaches
Narcolepsy and Diving
Spina bifida
Sprue (Coeliac Disease) and Diving
Syringomyelia
TIA [Little Strokes]
Cerebral Hemorrhage
Pseudotumor Cerebri



Neurological Effects of Diving

Chronic Adverse Effects Associated with Diving

Neurological Effects: Clinical Neurology

Neurological Effects: Neuropsychometric Changes

NeuroimagingNeurological Effects: Electrophysiology

Oxygen Toxicity

References


Neurologic Complications of Scuba Diving
Adapted from Herbert Newton, MD, American Family Physician, June1, 2001
(Table Modified)


Disorder Clinical features Dive profile Treatment
Middle ear barotrauma of descent   Pain, dizziness, hearing loss, rupture or hemorrhage of tympanic membrane   During descent usually, possible during ascent   Improved equalization techniques, oral and nasal decongestants; antibiotics
Facial nerve baroparesis   Facial paralysis, resolves within hours   During ascent   No treatment
Inner ear barotrauma, round or oval window rupture,  (?Perilymph fistula)
  Dizziness, nausea, vomiting, ringing in ear, hearing loss; often associated with middle ear barotrauma   During descent usually, possible during ascent   ENT specialist evaluation, bed rest, head elevation, avoid straining, surgery if persistent.
Arterial gas embolism (pulmonary barotrauma)
  Stupor, confusion, coma, seizures, focal weakness, visual loss   Within five minutes of surfacing (> 80 percent) or during ascent; significant time-depth exposure not required. Usually a rapid ascent.
  100 percent oxygen, immediate United States Navy Table 6 algorithm recompression (HBOT), supportive care
Inner ear DCS   Dizziness, nausea, emesis, rapid eye movement, ringing in ear, hearing loss   Within 30 to 60 minutes of surfacing (> 50 percent), 90 percent by six hours; significant time-depth exposure required   Same as above
Cerebral DCS   Confusion, focal weakness, fatigue, visual loss, double vision, slurred speech, staggering walk, headache   Same as above   Same as above
Spinal cord DCS   Tingling/sensory loss in trunk and/or extremities, leg weakness, loss of bowel/bladder function   Same as above   Same as above
Headache (arterial gas embolism or DCS)   Severe generalized headache associated with alteration of consciousness and other signs   Usually develops within minutes of ascent, may persist without recompression treatment   Same as above; analgesics
Oxygen toxicity   Focal seizures, visual constriction, nausea, vomiting, dizziness, tingling, rare generalized seizures   Occurs at depth, associated with use of rebreathers and nitrox at depth.
  Reduce depth and oxygen exposure, supportive care, seizure management; see arterial gas embolism treatment


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