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Jornal de Pediatria
Print version ISSN 0021-7557
On-line version ISSN 1678-4782
BRITO, Adriana Rocha et al. Central pontine and extrapontine myelinolysis: report of a case with a tragic outcome. J. Pediatr. (Rio J.) [online]. 2006, vol.82, n.2, pp.157-160. ISSN 0021-7557. http://dx.doi.org/10.1590/S0021-75572006000200014.
OBJECTIVE: To report a pediatric case of central pontine and extrapontine myelinolysis, a rare neurological disease often associated with rapid correction of hyponatremia. DESCRIPTION: A 15 year-old female adolescent developed locked-in syndrome during severe hyponatremia. Brain magnetic resonance imaging was consistent with the diagnosis of central pontine and extrapontine myelinolysis. COMMENTS: Serum sodium correction should proceed slowly and cautiously, based upon a careful calculation of sodium deficit, in order to minimize metabolic stress and avoid the occurrence of this dreadful complication, which has a tragic outcome in most cases. There is no scientifically proved effective treatment for myelinolysis, and severe cases usually have a dismal prognosis.
Keywords : Central pontine myelinolysis; extrapontine myelinolysis; osmotic demyelination; hyponatremia; magnetic resonance imaging; adolescence.