Abstract
Introduction: Central pontine myelinolysis (CPM) is a well-recognized syndrome that is related to various conditions such as rapid correction of hyponatremia and chronic alcoholism. Case Report: We report a case of a recently discharged patient with dysarthria, vertigo, and progressive gait changes, with radiological evidence of CPM, but without the expected rapid correction of hyponatremia seen in other patients that developed CPM. Conclusion: CPM is rare without severe hyponatremia of 120 meq/L or less, but there are other factors that contribute to the development of CPM, that may be unrelated to hyponatremia. Severe alcohol abuse, acute pancreatitis, and subsequent poor nutritional intake were likely the major factors in inducing osmotic injury in this case, which lead to CPM.
Highlights
INTRODUCTIONCentral Pontine myelinolysis (CPM), known as osmotic demyelination syndrome, is defined as a neurological disorder caused by damage of the myelin sheath of the nerve cells in the pons [1]
Central pontine myelinolysis (CPM) is a well-recognized syndrome that is related to various conditions such as rapid correction of hyponatremia and chronic alcoholism
Central Pontine myelinolysis (CPM), known as osmotic demyelination syndrome, is defined as a neurological disorder caused by damage of the myelin sheath of the nerve cells in the pons [1]
Summary
Central Pontine myelinolysis (CPM), known as osmotic demyelination syndrome, is defined as a neurological disorder caused by damage of the myelin sheath of the nerve cells in the pons [1]. There are other case reports of patients developing CPM that are not related to profound hyponatremia or the rapid correction of hyponatremia. She initially hid the information of her heavy alcohol drinking which delayed the diagnosis process, and she had a hospital stay of 10 days During her last admission, she initially had some hyponatremia with sodium level 122, and was corrected slowly to 132 in 3 days. The morning before coming back to the emergency department, she was getting juice out of the fridge when the room started to spin Her legs became very weak and she stumbled to the floor. Since review of previous admission records showed a slowly corrected hyponatremia, that raised sodium levels only 10 meq/L over three days, this was not necessary. Patient’s neurologic deficits slightly improved over her four day admission, and she was discharged to a rehabilitation center
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