Isolated extra pontine myelinolysis presenting as acute onset parkinsonism.
A 50-year-old woman was brought to the emergency department with complaints of altered mental status, her serum sodium at that time was 103 mmol/l. Slow correction of hyponatraemia was started but despite every effort serum sodium rise was rapid. Although the patient improved initially, after 4 days she presented with features of parkinsonism. MRI brain was done and it was suggestive of features of EPM. She responded well to levodopa plus carbidopa therapy.
Department of General Medicine, J N Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India. imranrizvi09@gmail.com
Imran
I
Rizvi
Mehtab
M
Ahmad
Ankush
A
Gupta
Noorin
N
Zaidi
D000208:Acute Disease; D000978:Antiparkinson Agents / Q000627:therapeutic use; D002230:Carbidopa / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000150:complications* / Q000188:drug therapy; D007980:Levodopa / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D017590:Myelinolysis, Central Pontine / Q000175:diagnosis / Q000209:etiology*; D010302:Parkinson Disease, Secondary / Q000188:drug therapy / Q000209:etiology*; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000009:adverse effects*
D000978:Antiparkinson Agents; D004338:Drug Combinations; D012462:Saline Solution, Hypertonic; C009265:carbidopa, levodopa drug combination; D007980:Levodopa; D002230:Carbidopa