Journal
ANNALES FRANCAISES D ANESTHESIE ET DE REANIMATION
Volume 28, Issue 1, Pages 96-99Publisher
ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER
DOI: 10.1016/j.annfar.2008.11.010
Keywords
Central pontine myelinolysis; Osmotic demyelination syndrome; Hyponatraemia; Hypokalaemia; Chronic alcohol abuse; Denutrition
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Central pontine myelinolysis covers very different clinical aspects, ranging from discrete tremor to quadriplegia. Rapid correction of hyponatraemia is a well-known risk factor, particularly in chronic alcohol abusers. We describe the case of a 46-year-old chronic alcoholic, suffering from denutrition. He developed a quadriplegia and a facial diplegia two weeks after a slow correction of a chronic hyponatraemia associated with hypokalaemia. Central pontine myelinolysis was formally diagnosed by MRI findings. In our case, the correction of hyponatraemia is not the only causal agent of this syndrome; hypokalaemia and denutrition seem to be predisposing factors too. For these reasons, glial cells are more vulnerable to osmotic variations. Despite of severe initial symptoms, the evolution was favourable with a quasi complete recovery. (C) 2008 Elsevier Masson SAS. All rights reserved.
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