[Pontine and extrapontine myelinolysis].
BACKGROUND
Myelinolysis is defined as acute demyelinating disorder, associated with flaccid quadriplegia, speech and swallowing impairment. The pathogenesis is usually related to hydroelectrolytic imbalance, particularly with severe hyponatremia and its rapid correction. The imagiologic diagnostic is commonly done by magnetic resonance imaging.


OBJECTIVE
The authors present a clinical case focusing on the follow up, rehabilitation program, and giving importance to functionality gains. The main clinical intercurrences related to the late diagnosis are also reported.


METHODS
A female patient with documented past psychiatric history and polidipsia was admitted with repeated seizures unsuccessfully controlled by drugs. Hyponatremia was identified and corrected. After the correction, a quadriplegia and a generalized hypotonia were noticed and the patient underwent magnetic resonance imaging. The imaging findings were consistent with the diagnosis of central pontine and extrapontine myelinolysis.
Marreiros
Humberto
H
Serviço de Medicina Física e Reabilitação, Hospital Dona Estefânia, Lisboa.
Santos
Rui
R
Santos
Susana
S
Tomás
Rita
R
Marques
Alexandra
A
Veiga
Eugénia
E
D003711:Demyelinating Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D017590:Myelinolysis, Central Pontine / Q000150:complications / Q000175:diagnosis / Q000628:therapy