A Case of Osmotic Demyelination Presenting with Severe Hypernatremia
Electrolytes & Blood Pressure
;
: 30-36, 2015.
Article
in English
| WPRIM
| ID: wpr-16300
ABSTRACT
Osmotic demyelination syndrome is a demyelinating disorder associated with rapid correction of hyponatremia. But, it rarely occurs in acute hypernatremia, and it leads to permanent neurologic symptoms and is associated with high mortality. A 44-year-old woman treated with alternative medicine was admitted with a history of drowsy mental status. Severe hypernatremia (197mEq/L) with hyperosmolality (415mOsm/kgH2O) was evident initially and magnetic resonance imaging revealed a high signal intensity lesion in the pons, consistent with central pontine myelinolysis. She was treated with 0.45% saline and 5% dextrose water and intravenous corticosteroids. Serum sodium normalized and her clinical course gradually improved. Brain lesion of myelinolysis also improved in a follow-up imaging study. This is the first report of a successful treatment of hypernatremia caused by iatrogenic salt intake, and it confirms the importance of adequate fluid supplementation in severe hypernatremia.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Sodium
/
Brain
/
Complementary Therapies
/
Pons
/
Magnetic Resonance Imaging
/
Water
/
Follow-Up Studies
/
Mortality
/
Demyelinating Diseases
/
Adrenal Cortex Hormones
Type of study:
Observational study
/
Prognostic study
Limits:
Adult
/
Female
/
Humans
Language:
English
Journal:
Electrolytes & Blood Pressure
Year:
2015
Type:
Article
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