A THERAPEUTIC EFFECT OF STEROIDS ON OSMOTIC DEMYELINATION SYNDROME DUE TO HYPONATREMIA IN OLD AGE WITH ALMOST COMPLETE RECOVERY

amishi amishi; NITIN RATHOD; DR KRISHNA SHAH

doi:10.15713/ins.bhj.107

Authors

amishi amishi a:1:{s:5:"en_US";s:6:"doctor";}
NITIN RATHOD
DR KRISHNA SHAH

DOI:

https://doi.org/10.15713/ins.bhj.107

Abstract

77 yrs. Old male presented with metabolic encephalopathy following hyponatremia. Clinically patient improved following correction of Sodium within 5 days and sent home. After 6 days of discharge, patient was readmitted with central pontine myelinolysis manifested as quadriplegia with lower cranial nerve palsy. Patient improved dramatically following methyl prednisolone therapy to complete recovery.

References

Kallakatta RN, Radhakrishnan A, Fayaz RK, Unnikrishnan JP, Kesavadas C, Sarma SP. Clinical and functional outcome and factors predicting prognosis in osmotic demyelination syndrome (central pontine and/or extrapontine myelinolysis) in 25 patients. J Neurol Neurosurg Psychiatry. 2011 Mar;82(3):326-31. [PubMed]

Sterns RH, Riggs JE, Schochet SS., Jr Osmotic demyelination syndrome following correction of hyponatremia. N Engl J Med. 1986;314(24):1535–1542. [PubMed] [Google Scholar]

Giuliani C, Peri A. Effects of Hyponatremia on the Brain. J Clin Med. 2014 Oct 28;3(4):1163-77. doi: 10.3390/jcm3041163. PMID: 26237597; PMCID: PMC4470176

Arieff AI, Llach F, Massry SG. Neurological manifestations and morbidity of hyponatremia: correlation with brain water and electrolytes. Medicine (Baltimore). 1976 Mar;55(2):121-9. doi: 10.1097/00005792-197603000-00002. PMID: 1256311.

Ruzek KA, Campeau NG, Miller GM. Early diagnosis of central pontine myelinolysis with diffusion-weighted imaging. AJNR Am J Neuroradiol. 2004 Feb;25(2):210-3. PMID: 14970019; PMCID: PMC7974598.

Bibl D, Lampl C, Gabriel C, Jüngling G, Brock H, Köstler G. Treatment of central pontine myelinolysis with therapeutic plasmapheresis. Lancet. 1999 Apr 03;353(9159):1155. [PubMed]

Grimaldi D, Cavalleri F, Vallone S, Milanti G, Cortelli P. Plasmapheresis improves the outcome of central pontine myelinolysis. J Neurol. 2005 Jun;252(6):734-5. [PubMed]

Sugimura Y, Murase T, Takefuji S, Hayasaka S, Takagishi Y, Oiso et al.,Y, Murata Y.

Protective effect of dexamethasone on

osmotic-induced demyelination in rats. Exp Neurol. 2005 Mar;192(1):178-83. [PubMed]