EXTRAPONTINE MYELINOLYSIS AND BEHAVIORAL-CHANGE AFTER TRANSSPHENOIDALPITUITARY SURGERY - CASE-REPORT

OBJECTIVE AND IMPORTANCE: Rapid correction of hyponatremia is consider ed the usual cause of central pontine myelinolysis and extrapontine my elinolysis. Little has been reported about mental changes associated w ith this disorder or its occurrence after transsphenoidal surgery. CLI NICAL PRESENTATION: A 24-year-old woman suddenly developed markedly ab normal behavior associated with rapid correction of hyponatremia 11 da ys after undergoing transsphenoidal surgery for a prolactin-secreting pituitary adenoma. INTERVENTION: Magnetic resonance imaging and positr on emission tomography with 18F-fluorodeoxyglucose showed bilateral ca udate nuclei and putaminal lesions. Gradual, complete clinical resolut ion preceded the resolution that was revealed by magnetic resonance im aging. CONCLUSION: We emphasize the importance of cautious correction with frequent electrolyte determinations and attention to behavioral c hanges in the management of delayed hyponatremia after pituitary tumor surgery.