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Osmotic Myelinolysis, Central Pontine Myelinolysis
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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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View Article: MedPix Image - MedPix Case
Affiliation: University of Iowa Health Care
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.
