Neurological manifestations of decompression illness in recreational divers-the Cozumel experience

Neurological signs and symptoms are common in recreational divers with decompression illness (DCI). The spectrum of neurological manifestations, temporal profile, and laboratory findings are described in a large series of 200 consecutive recreational divers treated for DCI. The Hyperbaric Medicine Unit charts of 200 recreational divers treated for DCI were reviewed and analyzed. The cohort was mainly male, with a median age of 40 years, and quite experienced, with a median of 100 prior dives. In 44 divers (22%) a rapid ascent was documented. The median time to onset of neurological symptoms was 60 minutes after surfacing. One hundred seventy-seven of 200 divers (88.5%) had at least one symptom of neurological DCI at presentation. The most common neurological manifestations were paresthesia, dysesthesia, incoordination, motor weakness, and dizziness. Paresthesias were associated with significantly younger (p=0.003) and less experienced (p=0.03) divers. Similar but less significant correlations were noted for dysesthesias. Female divers were significantly more likely to experience painful skin symptoms (p<0.001). Neurological manifestations are common in recreational divers treated for DCI. Neurological DCI and paresthesias are more likely to occur in younger and less experienced divers.