Extrapyramidal syndrome responsive to dopaminergic treatment following recovery from central pontine myelinolysis.
A 52-year-old woman developed severe hyponatremia following treatment for hypertension with chlorthalidone. Rapid correction of hyponatremia resulted in coma, quadriplegia and hypopnea compatible with central pontine myelinolysis. She recovered with residual facial hypomimia, bradykinesia, cogwheel rigidity and coarse resting tremor, responding to dopaminergic treatment. Her symptoms and signs, which are quite similar to idiopathic Parkinson's disease, are still responsive to treatment 7 years after onset.
Sadeh
M
M
Department of Neurology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Goldhammer
Y
Y
D001480:Basal Ganglia Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D001712:Biperiden / Q000008:administration & dosage*; D002230:Carbidopa / Q000008:administration & dosage*; D002752:Chlorthalidone / Q000008:administration & dosage / Q000009:adverse effects*; D003128:Coma / Q000139:chemically induced / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007010:Hyponatremia / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D007980:Levodopa / Q000008:administration & dosage*; D008090:Lisuride / Q000008:administration & dosage; D008875:Middle Aged; D009460:Neurologic Examination / Q000187:drug effects; D010302:Parkinson Disease, Secondary / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D011149:Pons / Q000187:drug effects*; D011782:Quadriplegia / Q000139:chemically induced / Q000188:drug therapy; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000009:adverse effects; D014057:Tomography, X-Ray Computed
D012462:Saline Solution, Hypertonic; D001712:Biperiden; D007980:Levodopa; D008090:Lisuride; D002230:Carbidopa; D002752:Chlorthalidone