Locked-in Syndrome due to Central Pontine Myelinolysis: Case Report.
10.5535/arm.2014.38.5.702
- Author:
Min Kyun SOHN
1
;
Jin Hee NAM
Author Information
1. Department of Rehabilitation Medicine, Chungnam National University School of Medicine, Daejeon, Korea. shapil21@cnuh.co.kr
- Publication Type:Case Report
- Keywords:
Central pontine myelinolysis;
Quadriplegia;
Recovery of function
- MeSH:
Adult;
Alcoholics;
Blinking;
Brain;
Bulbar Palsy, Progressive;
Extremities;
Gait;
Gravitation;
Humans;
Hyponatremia;
Joints;
Liver Diseases;
Magnetic Resonance Imaging;
Male;
Muscles;
Myelinolysis, Central Pontine*;
Organization and Administration;
Pons;
Quadriplegia*;
Recovery of Function;
Rehabilitation;
Sodium;
Unconsciousness
- From:Annals of Rehabilitation Medicine
2014;38(5):702-706
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
