A Case of Osmotic Demyelination Presenting with Severe Hypernatremia.
- Author:
Min Jee HAN
1
;
Do Hyoung KIM
;
Young Hwa KIM
;
In Mo YANG
;
Joon Hyung PARK
;
Moon Ki HONG
Author Information
- Publication Type:Case Report
- Keywords: Hypernatremia; Osmotic demyelination syndrome; Magnetic resonance imaging
- MeSH: Adrenal Cortex Hormones; Adult; Brain; Complementary Therapies; Demyelinating Diseases*; Female; Follow-Up Studies; Glucose; Humans; Hypernatremia*; Hyponatremia; Magnetic Resonance Imaging; Mortality; Myelinolysis, Central Pontine; Neurologic Manifestations; Pons; Sodium; Water
- From:Electrolytes & Blood Pressure 2015;13(1):30-36
- CountryRepublic of Korea
- Language:English
- Abstract: Osmotic demyelination syndrome is a demyelinating disorder associated with rapid correction of hyponatremia. But, it rarely occurs in acute hypernatremia, and it leads to permanent neurologic symptoms and is associated with high mortality. A 44-year-old woman treated with alternative medicine was admitted with a history of drowsy mental status. Severe hypernatremia (197mEq/L) with hyperosmolality (415mOsm/kgH2O) was evident initially and magnetic resonance imaging revealed a high signal intensity lesion in the pons, consistent with central pontine myelinolysis. She was treated with 0.45% saline and 5% dextrose water and intravenous corticosteroids. Serum sodium normalized and her clinical course gradually improved. Brain lesion of myelinolysis also improved in a follow-up imaging study. This is the first report of a successful treatment of hypernatremia caused by iatrogenic salt intake, and it confirms the importance of adequate fluid supplementation in severe hypernatremia.
