Korean Journal of Nephrology 2007;26(3):342-347.
Complete Neurological Recovery in Two Cases of Osmotic Demyelination Syndrome Following Rapid Correction of Chronic Hyponatremia
Eun-Young Kim, M.D.1, Joo-Hark Yi, M.D.1 , Useok Noh, M.D.1, Sang-Woong Han, M.D.1 Kyu-Yong Lee, M.D.1 and Ho-Jung Kim, M.D.1
Departments of Internal Medicine1 and Neurology2
Hanyang University Guri Hospital, Guri, Korea
만성 저나트륨혈증의 빠른 교정 후 발생한 삼투성 탈수초 증후군에서 신경학적으로 완전한 회복을 보인 2예
김은영1 이주학1 노유석1 한상웅1 이규용2 김호중1
한양대학교 구리병원 내과1, 신경과2
Abstract
The osmotic demyelination syndrome (ODS) is a distinctive clinical entity with characteristic MR features in the central pons (central pontine myelinolysis, CPM) and other locations (extrapotine myelinolysis, EPM). ODS is mainly seen following rapid correction of the serum sodium level in hyponatremic patients. In the past, ODS used to be considered as fatal. However, some recent reports have described cases of survival from this syndrome, but most survivors seem to suffer irreversible neurological deficits. We report one case of 46-year-old woman who developed stupor at day 7 and the other case of 56-year-old woman with drowsiness, dysarthria and dysphagia at day 3 following the correction of hyponatremia. In both cases, the serum potassium levels were low at the time of presentation with hyponatremia. By means of brain MRI, the first case was diagnosed as CPM with EMP and the second case as isolated EPM. With conservative treatments, complete neurological recovery was achieved at 4-6 weeks after onset of ODS.
Key Words: Central pontine myelinolysis, Extrapontine myelinolysis, Hyponatremia, Magnetic Resonance Imaging


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