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2014, Number 2

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Rev Fac Med UNAM 2014; 57 (2)

Central and peripheral pontine Myelinolysis: case report and review of literature

Madinaveitia TJ, Laventman GJ, Fraind MG

Language: Spanish
References: 15
Page: 25-30
PDF size: 299.55 Kb.


ABSTRACT

Central pontine myelinolysis or osmolar demielinization syndrome is a very well-known disorder in patients with severe hyponatremia that undergo to a rapid sodium replacement. It is clinically described as a pseudobulbar palsy, with tetraparesis, and encephalopathy, that can also show generalized rigidity, ataxia and the presence of abnormal movements. It consists of a non-inflammatory demielinization secondary to neuronal swelling or edema, at the pontine level and in other extrapontine locations. It is an infrequent pathology that carries a bad prognosis and where the only available treatment is prolonged rehabilitation. Herein we inform the case of a 63 year old male, with a progressive neurological deficit following a surgical intervention and rapid replacement of a severe hyponatremia. The patient required a prolonged in hospital stay and further rehabilitation, although the neurological sequels actually are not disabling. It is essential to recognize hyponatremia and to perform an adequate correction of sodium levels to avoid this complication.


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