A case of osmotic demyelination presenting with severe hypernatremia
- Authors
- Han, M.J.; Kim, D.H.; Kim, Y.H.; Yang, I.M.; Park, J.H.; Hong, M.K.
- Issue Date
- Jun-2015
- Publisher
- Korean Society of Electrolyte and Blood Pressure Research
- Keywords
- Hypernatremia; Magnetic resonance imaging; Osmotic demyelination syndrome
- Citation
- Electrolyte and Blood Pressure, v.13, no.1, pp 30 - 34
- Pages
- 5
- Journal Title
- Electrolyte and Blood Pressure
- Volume
- 13
- Number
- 1
- Start Page
- 30
- End Page
- 34
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/64546
- DOI
- 10.5049/EBP.2015.13.1.30
- ISSN
- 1738-5997
2092-9935
- 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 (197 mEq/L) with hyperosmolality (415 mOsm/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. Copyright © 2015 The Korean Society of Electrolyte Metabolism.
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