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Journal of The Korean Society of Emergency Medicine 1994;5(2): 281-286. |
| CENTRAL PONTINE MYELINOLYSIS FOLLWING RAPID CORRECTION OF HYPONATREMIA |
| Wen Joen Chang, Sung Wook Choi, Tae Sik Hwang, Han Shick Lee |
| Department of Emergency Medicine, Yong Dong Severance Hospital YUMC |
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Published online: December 31, 1994. |
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| ABSTRACT |
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Central pontine myelinolysis(CPM) was first described by Adams et al. in 1959 to denote the symmetric area of myelin damage found in the centre of the basis pontis. This disease has now been recognized throughout the world in both sexes and in all age group. And the derangement of serum sodium, especially hyponatremia, have been identified to be the factor most closely associated with CPM(i.e. rapid correction of hyponatremia may cause myelinolytic lesions on brain). Large CPM lesions may cause quadriplegia, lock-in syndrome and occasionally neuro ophthalmic features. Small lesions are often asymptomatic. Since it is not a treatable disease, clinician might endeavored to prevent its develoment ; correcting hyponatremia not exceeding 12 mEq/L/24hrs on first 24 hours and more moderation of correction of following days.
We experienced a 76-year-old female patient who suffered severe symptomatic hyponatremia thought to be caused by SIADH(syndrome of inappropriate secretion of anti-diuretic hormone) secondary to peumonia. Rapid correction of hyponatremia resulted in mental deterioration and quadriparesis. The brain MRI(magnetic resonance imaging) showed myelinolysis on both pons and extrapontine areas. 68 days after admission, she was quadriplegia with pseudobulbar palsy.
We report this case with literature reviews. |
| Key words:
Hyponatremia, CPM |
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