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J Korean Soc Emerg Med > Volume 18(2); 2007 > Article
Journal of The Korean Society of Emergency Medicine 2007;18(2): 168-172.
A Case of Central Pontine Myelinolysis Presenting as Continuous Nausea in the 16th week of Pregnancy
Sun Pyo Kim, Seong Jung Kim, Nam Soo Cho
Department of Emergency Medicine, Chosun University Hospital, Gwangju, Korea. nschoer@naver.com
Central pontine myelinolysis (CPM) is a demyelinating disease of the pons often associated as well with the demyelination of extrapontine areas of the central nervous system. Although the etiology and pathogenesis are unclear, CPM is usually associated with states such as too rapid correction of hyponatremia, alcohol intoxication, malnutrition, liver disease, burn, cancer, addison's disease, dehydrated disease, and electrolyte imbalance. Clinical presentations are nonspecific but are typically characterized by confused mentation, bulbar or pseudobulbar palsy (dysarthria, dysphagia, tetraplegia), rock-in syndrome, and common symptoms such as lethargy and dysarthria. Brain magnetic resonance imaging(MRI) in CPM results in diffuse high signal intensity in the pons on T2-weighted images, and shows slightly decreased signal intensity and no enhancement in the central pons on T1-weighted images. We described a case of a 30-year-old woman presenting with continuous nausea and vomiting in the 16th week of pregnancy. In order to achieve early diagnosis of CPM, We recommend that emergency physicians should consider CPM during differential diagnosis. Prompt diagnosis and management of associated complications are essential for favorable clinical outcomes in CPM.
Key words: Central pontine myelinolysis, Nausea and Vomiting
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