Extrapontine Myelinolysis following Extreme Hypernatremia and Hyperosmolarity

Case Reports in Pediatrics
Jan-Niclas SchwadeMatthias Endmann

Abstract

We present a case of a nearly 3-year-old girl who was admitted to hospital due to severe hypernatremia (196 mmol/l). Her medical history included central hypothyreosis and growth hormone deficiency. Rehydration and normalization of sodium was achieved according to guidelines. On the fourth day of hospitalization, the patient developed tremor, ataxia, and rigor. Cranial magnetic resonance imaging (cMRI) was performed and (mis)interpreted for meningoencephalitis, with corresponding diagnostic and therapeutic implications. The patient had extrapontine myelinolysis. The child recovered completely after hospitalization for nearly 2 weeks.

References

Nov 1, 1974·Archives of Internal Medicine·F R DeRubertisB B Davis
Jul 31, 2013·Biochemia Medica·Lidija Dobsa, Kido Cullen Edozien
Sep 16, 2014·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·T D SinghA A Rabinstein
Jul 28, 2016·Pediatrics International : Official Journal of the Japan Pediatric Society·Ryoji AokiShori Takahashi
Apr 22, 2017·The Journal of Pediatrics·Janaki D VakhariaLisa Swartz Topor

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