[Severe hyponatraemia and central pontine myelinolysis: be careful with other factors!].
Central pontine myelinolysis covers very different clinical aspects, ranging from discrete tremor to quadriplegia. Rapid correction of hyponatraemia is a well-known risk factor, particularly in chronic alcohol abusers. We describe the case of a 46-year-old chronic alcoholic, suffering from denutrition. He developed a quadriplegia and a facial diplegia two weeks after a slow correction of a chronic hyponatraemia associated with hypokalaemia. Central pontine myelinolysis was formally diagnosed by MRI findings. In our case, the correction of hyponatraemia is not the only causal agent of this syndrome; hypokalaemia and denutrition seem to be predisposing factors too. For these reasons, glial cells are more vulnerable to osmotic variations. Despite of severe initial symptoms, the evolution was favourable with a quasi complete recovery.
Ruiz
S
S
Coordination d'anesthésie-réanimation, hôpital Purpan, CHU de Toulouse, place du Docteur-Baylac, TSA 40031, 31059 Toulouse cedex 9, France. nanieruiz@yahoo.fr
Alzieu
M
M
Niquet
L
L
Vergne
S
S
Lathuile
D
D
Campistron
J
J
D000437:Alcoholism / Q000150:complications; D000465:Algorithms; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced; D007010:Hyponatremia / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D044342:Malnutrition / Q000209:etiology; D008875:Middle Aged; D017590:Myelinolysis, Central Pontine / Q000150:complications*; D009457:Neuroglia / Q000502:physiology