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Osmotic Myelinolysis, Central Pontine Myelinolysis

Smoker WS - MedPix (2009)

View Article: MedPix Image - MedPix Case

Affiliation: University of Iowa Health Care

ABSTRACT

Diagnosis: Osmotic Myelinolysis, Central Pontine Myelinolysis

History: 50 y.o. man with EtOH abuse presenting with intoxication and hypernatremia. Complains of progressive upper and lower extremity weakness on Day 5 of admission

Findings: Central pontine MRI signal abnormalities with sparing of the peripheral pontine fibers. T1 signal hypointense, T2 and FLAIR signal hyperintense. Mild diffusion restriction with corresponding low ADC.

Ddx: Pontine ischemia, demyelinating disease or metabolic disease.

Dxhow: Classic radiographic findings.

Exam: Neurologic exam: Slurred speech. Oriented only to year and name. Poor concentration. Bilateral nystagmus. Positive for weakness 2/5 in proximal muscles of upper and lower extremity. Decreased vibratory sensation in feet and ankles. Bilateral upgoing toes. Unable to stand on own. Labs: Sodium on admission was 171 mEq/L with glucose 105mg/dL. 6 hours later Na++ =169mEq/L; 24 hours later Na++ =164 mEq/L; 48 hours later Na++ =138 mEq/L.

No MeSH data available.


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Osmotic Myelinolysis, Central Pontine Myelinolysis

Smoker WS - MedPix (2009)

Replace this - DESCRIPTION OF THE IMAGE OR FINDINGS.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1233&req=5

MPX1233_synpic51028: Replace this - DESCRIPTION OF THE IMAGE OR FINDINGS.

View Article: MedPix Image - MedPix Case

Affiliation: University of Iowa Health Care

ABSTRACT

Diagnosis: Osmotic Myelinolysis, Central Pontine Myelinolysis

History: 50 y.o. man with EtOH abuse presenting with intoxication and hypernatremia. Complains of progressive upper and lower extremity weakness on Day 5 of admission

Findings: Central pontine MRI signal abnormalities with sparing of the peripheral pontine fibers. T1 signal hypointense, T2 and FLAIR signal hyperintense. Mild diffusion restriction with corresponding low ADC.

Ddx: Pontine ischemia, demyelinating disease or metabolic disease.

Dxhow: Classic radiographic findings.

Exam: Neurologic exam: Slurred speech. Oriented only to year and name. Poor concentration. Bilateral nystagmus. Positive for weakness 2/5 in proximal muscles of upper and lower extremity. Decreased vibratory sensation in feet and ankles. Bilateral upgoing toes. Unable to stand on own. Labs: Sodium on admission was 171 mEq/L with glucose 105mg/dL. 6 hours later Na++ =169mEq/L; 24 hours later Na++ =164 mEq/L; 48 hours later Na++ =138 mEq/L.

No MeSH data available.