Delayed and extra-pontine myelinolysis after osmotic dysregulation.

نویسندگان

  • Vijay K Sharma
  • Rahul Rathakrishnan
چکیده

1 Division of Neurology, National University Hospital, Singapore Address for Correspondence: Dr Vijay Sharma, Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074. Email: [email protected] A 58-year-old Chinese man was admitted because of increasing lethargy and confusion over 4 days. He had been taking hydrochlorthiazide for hypertension and regularly consumed ethanol in moderation. Examination showed a conscious, well-hydrated man with slow verbal responses and unstable gait. Laboratory tests suggested hyponatremia due to the syndrome of inappropriate secretion of antidiuretic hormone (serum sodium 104 mmol/L, urine sodium 25 mmol/L, serum osmolality 213 mosm/kg and urine osmolality 439 mosm/kg). Thyroid function tests, computed tomographic (CT) scan of the brain, and chest X-ray were unremarkable. With intravenous thiamine and fluid

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Extra-Pontine Myelinolysis in a Case of Pan-hypopituitarism Due to Empty Sella Syndrome.

Rapid correction of hyponatremia is known to cause central pontine myelinolysis (CPM). It may concurrently involve other areas of brain as well, referred as extra-pontine myelinolysis (EPM). Isolated EPM however is a very rare occurrence. We present a case of EPM where the hyponatremia was secondary to hypothyroidism due to empty sella syndrome. Chronic hyponatremia should always be corrected s...

متن کامل

Treatable Leukoencephalopathy in a Patient with Hypophosphatemia

We report the first patient with pathologically proven leukoencephalopathy associated with hypophosphatemia. A 61-year-old woman had repetitive episodes of decreased consciousness with pontine and pallidal lesions and extensive leukoencephalopathy on MRI, later found to be associated with hypophosphatemia. Although hypophosphatemia has been linked to central pontine and extrapontine myelinolysi...

متن کامل

Resolving MR features in osmotic myelinolysis (central pontine and extrapontine myelinolysis).

Osmotic myelinolysis is a distinctive clinical syndrome with characteristic MR features in the central pons (central pontine myelinolysis) and in other locations (extrapontine myelinolysis). We describe the resolving MR features in an adolescent who has experienced complete neurologic recovery. Regions of involvement manifested increased T2 signal intensity. The extrapontine involvement was not...

متن کامل

Psychogenic polydipsia, hyponatremia and osmotic myelinolysis.

OBJECTIVE Description of a case of osmotic myelinolysis associated with hyponatremia produced as a consequence of compulsive water drinking. METHOD Case report and review of relevant literature. RESULTS Compulsive water drinking or psychogenic polydipsia is a common cause of hyponatremia among individuals with chronic mental illness. Central pontine myelinolysis and extrapontine myelinolysi...

متن کامل

Current Concepts in Pontine Myelinolysis: Review of Literature

Pontine myelinolysis (PM) was first described in 1959 by Adams et al. in alcoholic patients [1]. Also known as osmotic demyelination syndrome (ODS), PM is subdivided into central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) [2]. Each is identified at the level of demyelination either centered within the pons [1] or outside the pons [3], respectively. While the etiology of ODS ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Annals of the Academy of Medicine, Singapore

دوره 37 7  شماره 

صفحات  -

تاریخ انتشار 2008