Resolution of MRI findings in central pontine myelinosis associated with hypokalemia.
We report a case of a 20-year-old African-American female, hospitalized and treated for hyperemesis gravidarum and hypokalemia with a normal serum sodium level. Two to 3 days into her hospitalization, she developed urinary incontinence, weakness, and pain in her lower extremities. An MRI brain scan showed central pontine signal alteration, leading to a diagnosis of CPM. A 4-month follow-up MRI brain scan showed complete resolution of the central pontine signal, with symptomatic improvement manifested by resolution of urinary incontinence and increased strength. Our case describes CPM occurring secondary to hypokalemia, with resolution of characteristic MRI findings at follow-up. Sole hypokalemia-induced CPM is very rare. What makes our patient even more unique is the complete resolution of the central pontine lesion on follow-up MRI. The cause of this cannot be completely explained and warrants further study.
Patel
Shomeet V
SV
Department of Internal Medicine, Mercer University School of Medicine, Macon, GA 31201, USA. shomeet@yahoo.com
Parish
David C
DC
Patel
Rajendrakumar M
RM
Grimsley
Edwin W
EW
D000328:Adult; D001921:Brain / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006939:Hyperemesis Gravidarum / Q000097:blood; D007008:Hypokalemia / Q000097:blood / Q000150:complications*; D008279:Magnetic Resonance Imaging; D017590:Myelinolysis, Central Pontine / Q000175:diagnosis / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood; D012964:Sodium / Q000097:blood
D012964:Sodium