CENTRAL PONTINE MYELINOLYSIS - PAUCISYMPT OMATIC CASE-REPORT

The authors report a case of paucisymptomatic central pontine myelinol ysis (CMP). A 66 years olf female had severe hypochloronatremia and hy pokaliemia due to diuretic. Despite a slow hydroelectrolytic correctio n, she presented with dumbness and seizure. CT scan showed hypodensity of protuberance and magnetic resonance imaging (MRI) shown hypersigna l of protuberance and undercortex, compatible with central and extra p ontine myelinolysis. The long term clinical outcome was good, as MRI's data. Rapid and important correction of severe hyponatremia should be the most important factors of demyelination, secondary to interferenc e with cerebral adaptation mechanisms to hypoosmolality. These factors were not present in this case.