Central pontine and extrapontine myelinolysis: report of a case with a tragic outcome.
OBJECTIVE
To report a pediatric case of central pontine and extrapontine myelinolysis, a rare neurological disease often associated with rapid correction of hyponatremia.


METHODS
A 15 year-old female adolescent developed locked-in syndrome during severe hyponatremia. Brain magnetic resonance imaging was consistent with the diagnosis of central pontine and extrapontine myelinolysis.


CONCLUSIONS
Serum sodium correction should proceed slowly and cautiously, based upon a careful calculation of sodium deficit, in order to minimize metabolic stress and avoid the occurrence of this dreadful complication, which has a tragic outcome in most cases. There is no scientifically proved effective treatment for myelinolysis, and severe cases usually have a dismal prognosis.
Brito
Adriana Rocha
AR
Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil. adrianarochabrito@ig.com.br
Vasconcelos
Marcio Moacyr
MM
Cruz Júnior
Luiz Celso Hygino da
LC
Oliveira
Maria Emília D C Q de
ME
Azevedo
Adriana Rodrigues Miguel de
AR
Rocha
Luciana Graça Vieira
LG
Mendonça
Priscilla Costa
PC
D000293:Adolescent; D001921:Brain / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D008279:Magnetic Resonance Imaging; D017590:Myelinolysis, Central Pontine / Q000175:diagnosis* / Q000209:etiology; D012964:Sodium / Q000097:blood
D012964:Sodium