ABSTRACT
We present a case of a 50-year old man who developed mutism and a flaccid quadriparesis within 48 hours of presentation to hospital with severe hyponatraemia. A diagnosis of central pontine myelinolysis was made based on the clinical features and typical appearances on magnetic resonance imaging.
Subject(s)
Humans , Male , Middle Aged , Hyponatremia/complications , Myelinolysis, Central Pontine/etiology , Mutism/etiology , Quadriplegia/etiology , Hyponatremia/drug therapy , Hyponatremia/physiopathology , Myelinolysis, Central Pontine/diagnosis , Myelinolysis, Central Pontine/therapy , Quadriplegia/diagnosisABSTRACT
La mielinosis central pontima (MCP) es un sindrome neurológico que afecta a adultos jóvenes y de mediana edad y es habitualmente provocado por una corrección de la hiponatremia efectuada en forma demasiado rápida. La evolución clínica varía notablemente desde recuperación casi total a secuelas nerológicas severas e incluso la muerte. Se decribe un caso de mielinosis central pontina en un paciente con hiponatremia y alcoholista, que se presentó con un sindrome cerebeloso sin signos piramidales y en el que la velocidad de corrección del sodio sérico se realizó dentro de los límites recomendados. Se hace énfasis en que para evitar el desarrollo de la mielinosis central pontina, la corrección del sodio sérico en casos de hiponatremia no debe ser más rápida de 12mEg/L en 24 hs y no mayor de 0.5 a 1 m Eg/L/hora.
Subject(s)
Humans , Male , Myelinolysis, Central Pontine/diagnosis , Myelinolysis, Central Pontine/physiopathology , Myelinolysis, Central Pontine/therapyABSTRACT
Tha case of a 55 year old man who presented with severe global headache 8 hours after having been drinking heavily, and who over a two hour period developed deep coma and flaccid paralysis of all four extremities is reported. A CT scan of the brain was normal; however, on Magnetic Resonance Imaging (MRI) extensive hyperintense areas in the brain stem, mainly in the pons, were easily identified. Based upon the clinical and MRI findings a diagnosis of Central Pontine Myelinolysis was made. Following several months of supportive therapy the patient partially recovered and was able to leave the hospital.