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Vol. 4, No. 3, 2012
Issue release date: September – December
Section title: Published: November 2012

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Case Rep Neurol 2012;4:167–172
(DOI:10.1159/000345225)

Asymptomatic Central Pontine Myelinolysis: A Case Report

Shah S.O.a · Wang A.b · Mudambi L.c · Ghuznavi N.c · Fekete R.a
Departments of aNeurology, bNeurosurgery, and cMedicine, New York Medical College, Valhalla, N.Y., USA
email Corresponding Author

Assist. Prof. Dr. Robert Fekete

Department of Neurology

New York Medical College, Munger Pavilion, 4th Floor

40 Sunshine Cottage Road, Valhalla, NY 10595 (USA)

E-Mail robertfekete@hotmail.com

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Abstract

Introduction: Central pontine myelinolysis (CPM) is an acquired demyelinating lesion of the basis pontis that typically occurs after rapid correction of hyponatremia. There are only a few reported cases of patients without symptoms that have demonstrated CPM on imaging. Case Presentation: We report the case of a 26-year-old Hispanic male with history of alcohol abuse who was transferred to our medical center for acute onset diffuse abdominal pain. During his work up, a computed tomography scan demonstrated a large pancreatic mass. He underwent an endoscopic guided biopsy which demonstrated a rare and aggressive natural killer T cell lymphoma. His laboratory values were consistent with hyponatremia, which the medical team gently corrected. An MRI was performed for staging purposes which revealed findings consistent with CPM. A full neurological exam demonstrated no deficits. Materials and Methods: We conducted a PubMed search using the following keywords: asymptomatic, central, pontine, and myelinolysis in order to find other case reports of asymptomatic CPM. Results: Of the 29 results, only 6 previous case reports with English language abstracts of asymptomatic CPM were present since 1995. Conclusion: Despite slow correction of hyponatremia, CPM can be an important consequence, especially in patients with chronic alcoholism. Although this patient did not demonstrate any neurological deficits, the fact that there were changes seen on MRI should caution physicians in aggressively treating hyponatremia. Furthermore, if there is a decision to treat, then fluid restriction and reversal of precipitating factors (i.e. diuretics) should be used initially, unless there is concern for hypovolemia.

© 2012 S. Karger AG, Basel


  

Article Information

Published online: November 3, 2012
Number of Print Pages : 6
Number of Figures : 2,
Additional supplementary material is available online - Number of Parts : 1

  

Publication Details

Case Reports in Neurology

Vol. 4, No. 3, Year 2012 (Cover Date: September - December)

Journal Editor: Tatlisumak T. (Helsinki)
ISSN: 1662-680X (Print), eISSN: 1662-680X (Online)

For additional information: http://www.karger.com/CRN


Article / Publication Details

First-Page Preview
Abstract of Published: November 2012

Published online: 11/3/2012
Issue release date: September – December

Number of Print Pages: 6
Number of Figures: 2
Number of Tables: 0

ISSN: (Print)
eISSN: 1662-680X (Online)

For additional information: http://www.karger.com/CRN


Open Access License / Drug Dosage / Disclaimer

Open Access License: This is an Open Access article licensed under the terms of the Creative Commons Attribution-NonCommercial 3.0 Unported license (CC BY-NC) (www.karger.com/OA-license), applicable to the online version of the article only. Distribution permitted for non-commercial purposes only.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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