[Acute tetraplegia, diabetes mellitus (clin conference)].
A 48-year-old patient with massive obesity developed a dramatic increase of serum glucose and sodium concentration as first symptom of a so far unknown diabetes mellitus. A treatment with intravenous insulin infusion and administration of free water was initiated. Two weeks after this event he became comatose, developed dysphagia, a speech disorder and ocular bobbing; finally, he showed the picture of a complete tetraparesis. Computertomographic findings of the brain were unremarkable. Two weeks later physical findings of the patient showed a significant improvement. Dysphagia, speech disorder and even the tetraparesis disappeared. Computertomography of the brain now yielded a hypodense area within the pons. The symptoms can be understood as signs of central pontine myelinolysis, which may be due to hypo-osmolarity or fast equilibration of a hypo-osmolarity. The history of this patient is a rare example of a central pontine myelinolysis with spontaneous remission.
Hohage
H
H
Medizinische Poliklinik, Westfälische Wilhelms-Universität, Münster.
Welling
U
U
Stachon
A
A
Spieker
C
C
D048909:Diabetes Complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D017590:Myelinolysis, Central Pontine / Q000150:complications* / Q000000981:diagnostic imaging; D009765:Obesity; D011782:Quadriplegia / Q000209:etiology*; D012075:Remission, Spontaneous; D014057:Tomography, X-Ray Computed
Akute Tetraparese, Diabetes mellitus.