**13. Central nervous system**

Neurological findings are nonspecific and usually completely reversible**.** They can **r**ange from anxiety and restlessness to comatose state requiring mechanical ventilation. The early signs and symptoms are delirium, restlessness, confusion or anxiety. Diffuse encephalopathy and coma can ensue (Jacobson et al., 1986). Focal neurological deficits are common. These findings are frequently not responsive to correction of hypoxemia (Metting et al., 2009) and have infrequently been observed in absence of pulmonary involvement.
