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Indian Journal of Neurotrauma 2015; 12(01): 062-064
DOI: 10.1055/s-0035-1555022
Case Report
Neurotrauma Society of India

Sequential Evolution of Extrapontine and Pontine Myelinolysis: Role of Hypokalemia—A Case Report

S. K. Verma
1   Department of Neurosurgery, Command Hospital, Pune, India
,
M. N. Swamy
2   Department of Neurosurgery, Command Hospital, Lucknow, India
,
K. K. Yadav
1   Department of Neurosurgery, Command Hospital, Pune, India
,
N. Basantani
1   Department of Neurosurgery, Command Hospital, Pune, India
› Author Affiliations
Subject Editor:
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Publication History

26 November 2014

05 February 2015

Publication Date:
30 June 2015 (online)

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Abstract

Osmotic demyelination syndrome due to rapid correction of hyponatremia may present with myelinolysis at pontine and/or extrapontine locations. Of late, the role of hypokalemia in increasing the risk for demyelination is being recognised. A 57-year-old man underwent surgery for cervical myelopathy. Postoperatively, he developed hyponatremia and hypokalemia and went on to develop seizures followed by “locked in state”. Magnetic resonance imaging (MRI) after 8 days revealed extensive extrapontine myelinolysis. The patient recovered well over 8 weeks. Sequential development of MRI lesions and their resolution has been discussed.

Keywords

osmotic demyelination - hyponatremia - hypokalemia
 

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