Central pontine myelinolysis in a patient with anorexia nervosa.
Myelinolysis may occur as a severe complication of eating disorders, especially anorexia nervosa (AN). One of the most important reasons can be a rapid correction of hyponatremia caused by tubulopathy, water intoxication (WI), or abuse of diuretics in individuals with AN. METHOD AND RESULTS We report on a 24-year-old female patient with an 8-year history of AN. A rapid correction of severe hyponatremia and hypokalemia induced by WI led to central pontine myelinolysis, which was confirmed by magnetic resonance imaging (MRI) examination. Besides affective lability, incoherence, and an acute confusional state, surprisingly, no severe neurological symptoms emerged.


CONCLUSIONS
Thus, physicians should be aware of the risk of pontine myelinolysis with new psychiatric symptoms emerging in the absence of obvious neurological deficits.
Amann
B
B
Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany. benedikt.amann@psy.med.uni-muenchen.de
Schäfer
M
M
Sterr
A
A
Arnold
S
S
Grunze
H
H
D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D017590:Myelinolysis, Central Pontine / Q000150:complications* / Q000473:pathology