[Ethanol, water, salt and coma].
We report on a 52-year-old woman with liver cirrhosis who suddenly fell into deep coma after correction of an intercurrent hyponatremia. After exclusion of the commonest causes of coma, the MRI showed a symmetrical osmotic demyelination of both thalami. The newest epidemiological data, the pathophysiology of osmotic demyelination, the threats of the treatment of a prolonged severe hyponatremia as well as the therapeutic options in face of osmotic demyelination are discussed.
Spakowski
M
M
Interdisziplinäre Intensivstation, Stadtspital Waid, Zürich. margarete.spakowski@waid.zuerich.ch
Nikolic
N
N
Giambarba
C
C
D003128:Coma / Q000097:blood / Q000209:etiology*; D003937:Diagnosis, Differential; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000209:etiology* / Q000628:therapy*; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood / Q000150:complications* / Q000628:therapy*; D008111:Liver Function Tests; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D017590:Myelinolysis, Central Pontine / Q000175:diagnosis*; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000009:adverse effects*; D013786:Thalamic Diseases / Q000097:blood / Q000175:diagnosis*; D013788:Thalamus / Q000473:pathology; D014057:Tomography, X-Ray Computed
D012462:Saline Solution, Hypertonic