Locked-in Syndrome due to Central Pontine Myelinolysis: Case Report.
Central pontine myelinolysis (CPM) classically occurs in alcoholics, malnourished individuals, chronic liver diseases, and rapid correction of hyponatremia. This report presents locked-in syndrome due to CPM following rapid correction of hyponatremia. A 44-year-old male came to the hospital due to a short period of loss of consciousness. He was alert and had no focal neurological abnormalities at admission. The serum sodium concentration was 118 mEq/L and was corrected to 134 mEq/L in the first 18 hours. One week later, progressive weakness in limbs developed and he progressed to a complete quadriplegic state and bulbar palsy, with only eye blinking preserved. Brain magnetic resonance imaging revealed a characteristic hyperintense signal abnormality in both pons, so he was diagnosed to locked-in syndrome caused by CPM. The patient gradually improved following continuous intensive rehabilitation for more than 2 years. He was able to move all joint muscles against gravity in generally and he could gait under supervision.
Department of Rehabilitation Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
Min Kyun
MK
Sohn
Department of Rehabilitation Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
Jin Hee
JH
Nam
Central pontine myelinolysis; Quadriplegia; Recovery of function