| Extrapontine myelinolysis as presenting manifestation of adrenal failure: a case report. | |
| | |
MedLine Citation:
|
PMID: 20022023 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Hyponatremia is a fairly common metabolic disorder. Hyponatremic myelinolysis is a relatively rare, life threatening complication with poorly understood pathophysiology, varied clinical manifestations and uncertain treatment. This case report highlights the range of clinical and imaging phenomena associated with hyponatremic myelinolysis. METHODS: Case report. RESULT: A middle aged lady presented with an acute delirious state, hypotension and severe hyponatremia on a background of skin hyper-pigmentation and weight loss. Her clinical course evolved to an akinetic-rigid state and later to parkinsonism. Extensive investigations for recognizing a primary neurologic disorder, including brain MRI and CSF analysis were normal, though she had disseminated miliary tuberculosis involving multiple organs. Brain MRI changes characteristic of extrapontine myelinolysis appeared two weeks after the onset of symptoms. The patient recovered completely over several weeks. CONCLUSION: This case of hyponatremic extrapontine myelinolysis occurred as the presenting manifestation of adrenal failure secondary to disseminated tuberculosis. Extraponine myelinolysis is difficult to diagnose in the context of delayed brain MRI changes and can have a favorable outcome with modern management. |
| | |
Authors:
|
Arunodaya Gujjar; Ali Al-Mamari; P C Jacob; Rajiv Jain; Abdullah Balkhair; Abdullah Al-Asmi |
Related Documents
:
|
22263163 - Life-threatening simultaneous bilateral spontaneous tension pneumothorax - a case repor... 10811293 - A case of hypothalamic adrenal insufficiency manifested normal acth response to insulin... 1775843 - Gonococcemia associated with adult respiratory distress syndrome. |
Publication Detail:
|
Type: Case Reports; Journal Article |
Journal Detail:
|
Title: Journal of the neurological sciences Volume: 290 ISSN: 1878-5883 ISO Abbreviation: J. Neurol. Sci. Publication Date: 2010 Mar |
Date Detail:
|
Created Date: 2010-02-01 Completed Date: 2010-05-13 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0375403 Medline TA: J Neurol Sci Country: Netherlands |
Other Details:
|
Languages: eng Pagination: 169-71 Citation Subset: IM |
Affiliation:
|
Department of Medicine, Sultan Qaboos University, Muscat, Oman. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adrenal Glands
/
pathology Adrenal Insufficiency / complications*, microbiology, physiopathology Adult Antitubercular Agents / therapeutic use Basal Ganglia Diseases / etiology, pathology, physiopathology Brain / metabolism, pathology, physiopathology Brain Diseases, Metabolic / metabolism, pathology, physiopathology Delirium / etiology Female Humans Hyponatremia / complications*, physiopathology Hypotension / etiology Magnetic Resonance Imaging Muscle Rigidity / etiology Myelinolysis, Central Pontine / etiology*, pathology*, physiopathology Nerve Fibers, Myelinated / metabolism, pathology Treatment Outcome Tuberculosis, Miliary / complications* Weight Loss |
| Chemical | |
Reg. No./Substance:
|
0/Antitubercular Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: In situ precipitation of magnetic fluid encapsulated in giant liposomes.
Next Document: Neuronal and glial tau pathology in early frontotemporal lobar degeneration-tau, Pick's disease subt...