title: Extra-pontine myelinolysis secondary to hypernatremia induced by postpartum water restriction.
abstract: A young adult female with restricted water intake during the postpartum period presented with history of progressive weakness, dizziness and tendency to fall with generalized slowing of movement. On examination, patient was anaemic, febrile and stuporous. Investigations revealed hypernatremia, delta waves in electroencephalogram (EEG) and features suggestive of extra-pontine myelinolysis on magnetic resonance imaging (MRI) of brain. After correcting hypernatremia and instituting anti-cholinergic therapy, there was a gradual but steady improvement in neurological symptoms of the patient over a period of one week and the patient was discharged in a conscious, oriented and ambulant state. As such, neuroimaging findings can be crucial in diagnosing hypernatremic encephalopathy in the postpartum period.
authors.affiliation: 1 Department of Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India.
authors.forename: A
authors.initials: A
authors.lastname: Chhabra
authors.affiliation: 1 Department of Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India.
authors.forename: R
authors.initials: R
authors.lastname: Kaushik
authors.affiliation: 1 Department of Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India.
authors.forename: R M
authors.initials: RM
authors.lastname: Kaushik
authors.affiliation: 2 Neurology Department, Max Superspeciality Hospital, Dehradun, India.
authors.forename: D
authors.initials: D
authors.lastname: Goel
mesh_terms: D004569:Electroencephalography; D005260:Female; D006801:Humans; D006955:Hypernatremia / Q000209:etiology*; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D065837:Middle Cerebellar Peduncle / Q000000981:diagnostic imaging; D017590:Myelinolysis, Central Pontine / Q000000981:diagnostic imaging / Q000209:etiology*; D009434:Neural Pathways / Q000000981:diagnostic imaging; D049590:Postpartum Period; D014868:Water Deprivation; D055815:Young Adult
keywords: Extra-pontine myelinolysis; hypernatremia; postpartum water restriction