Ozone-Induced Encephalopathy Following Subcutaneous Ozone Injection: A Case Report
Gante C, Dias L. Cureus, 2025.
- Study type
- Case report
- People studied
- 1 person
- Population
- 55-year-old man with no significant past medical history, given a subcutaneous ozone injection at facial acupuncture points as an alternative therapy for seasonal allergies
- Published
- 2025, Cureus
- Identifiers
- PMID 41492606, DOI 10.7759/cureus.98527
What the authors reported
About 10 minutes after a subcutaneous ozone injection at acupuncture points in the face, the patient developed confusion, ataxia, and involuntary limb movements and was intubated. CT was normal; MRI showed transient cortical diffusion abnormalities. Symptoms resolved without specific therapy after 48 hours of ventilation, and a repeat MRI 4 days later was normal.
What limits this result
Single case report. The authors state that definitive causality cannot be established; the diagnosis of ozone-induced encephalopathy rests on timing and the exclusion of other causes. No ozone dose or volume is reported, and the patient did not attend the six-month follow-up.
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How the study was done
- Design
- Case report
Ozone-Induced Encephalopathy Following Subcutaneous Ozone Injection: A Case Report
- Setting
- Internal Medicine, Hospital de São José, Unidade Local de Saúde de São José, Lisbon, Portugal (author affiliation)
- Read from
- Read from the full text of the paper. Read on September 29, 2026.
Source: Abstract on PubMed
Study arms
| Group | Participants | What they received |
|---|---|---|
| Single patient | Not reported | Subcutaneous ozone injection as an alternative therapy for seasonal allergies; symptoms began about 10 minutes later |
Source: Full text on PubMed Central
What it measured
- Brain CT and MRI
- CT normal; MRI showed transient cortical diffusion abnormalities
- Initial management
- Levetiracetam started for a suspected seizure; intubated for airway protection and placed on mechanical ventilation
Given the suspicion of a seizure, levetiracetam 1000mg twice a day was initiated, and the patient was intubated for airway protection and placed on mechanical ventilation.
- Initial laboratory studies
- Leukocytosis (14.1 × 10⁹/L) with neutrophilia and an elevated D-dimer (5496 µg/L); kidney and liver function tests within normal limits
- Infection workup
- Blood cultures, cerebrospinal fluid analysis, and respiratory viral screening normal; HIV testing negative
- Electroencephalography
- Moderate encephalopathy without epileptiform activity; anticonvulsants discontinued
- Clinical course
- Mechanical ventilation for 48 hours, after which neurological symptoms resolved completely without specific therapy
- Follow-up MRI four days later
- Complete resolution of the previously noted cortical signal abnormalities
- Examination on the ward
- Free of neurological deficits; only mild subcutaneous emphysema noted
Safety as reported
Acute, reversible encephalopathy following subcutaneous ozone injection at acupuncture points in the faceWe present a case of acute, reversible encephalopathy following subcutaneous ozone injection at acupuncture points in the face, a route not recommended for any medical indication.
Source: Full text on PubMed Central
Follow-up
Three months, by telephone; the patient remained asymptomaticAt the three-month follow-up, a telephone consultation was conducted, during which the patient remained asymptomatic.
Source: Full text on PubMed Central
Funding and conflicts
All authors declared that no financial support was received from any organization for the submitted work
Source: Full text on PubMed Central
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