EXTRAPONTINE MYELINOLYSIS - TREATMENT WIT H TRH

Central pontine and extra-pontine myelinolysis are a well known compli cation of hyponatremia. Other causes may be present We report a case o f head injury in a 13 year-old girl, who recovered well after surgery for extra-dural hematoma, but presented endocrinological disorders wit h hyperglycemia followed by a severe hyponatremia. Despite the correct ion of these metabolic disorders, the patient became comatose, and MRI , on T2 weighted image, showed hyperintense signals in the basal gangl ia consistent with extra-pontine myelinolysis. The patient's state rem ained unchanged for six weeks. Since S. Konno and H. Wakui published c ases of myelinolysis who dramatically improved after TRH treatment, th e patient was given 0.6 mg i.v daily of TRH for six weeks. Improvement began within a few days, and continued until complete recovery.