title: Central pontine and extrapontine myelinolysis: report of a case with a tragic outcome.
abstract: 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.
authors.affiliation: Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, RJ, Brazil. adrianarochabrito@ig.com.br
authors.forename: Adriana Rocha
authors.initials: AR
authors.lastname: Brito
authors.forename: Marcio Moacyr
authors.initials: MM
authors.lastname: Vasconcelos
authors.forename: Luiz Celso Hygino da
authors.initials: LC
authors.lastname: Cruz Júnior
authors.forename: Maria Emília D C Q de
authors.initials: ME
authors.lastname: Oliveira
authors.forename: Adriana Rodrigues Miguel de
authors.initials: AR
authors.lastname: Azevedo
authors.forename: Luciana Graça Vieira
authors.initials: LG
authors.lastname: Rocha
authors.forename: Priscilla Costa
authors.initials: PC
authors.lastname: Mendonça
mesh_terms: 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
chemical_list: D012964:Sodium