scholarly journals A Case of Central Pontine Myelinolysis Unrelated Serum Sodium Level in Traumatic Brain Injury Patient

2022 ◽  
Vol 18 ◽  
Author(s):  
Eui Gyu Sin
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Serum Sodium ◽  
Sodium Level ◽  
Serum Sodium Level ◽  
Traumatic Brain Injury Patient ◽  
Central Pontine Myelinolysis ◽  
Pontine Myelinolysis ◽  
Injury Patient ◽  
Central Pontine

Ayurvedic understanding of Central Pontine Myelinolysis - A Case Report

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Anoop AS ◽  
Lakshmiprasad L. Jadhav ◽  
Sruthy Nair ◽  
Rohan Mohandas
Keyword(s):  
Serum Sodium Level ◽  
Central Pontine Myelinolysis ◽  
Chronic Alcoholism ◽  
Serum Electrolyte ◽  
Oral Medications ◽  
Shoulder Joints ◽  
Pontine Myelinolysis ◽  
Chief Complaints ◽  
Hyponatremic Encephalopathy ◽  
Central Pontine

A 56 year old male patient was admitted to S.D.M Ayurveda Hospital, Hassan, Karnataka with the confirmed diagnosis of Central Pontine Myelinolysis (CPM) on 11/12/17. The chief complaints were weakness of both hands and legs, stiffness in both hands and legs, pain in both shoulder joints, slurred speech, difficulty in walking with gait changes. H/O chronic alcoholism. MRI brain showed pontine and basal ganglia diffusion restriction - Acute Pontine Myelinolysis. The serum electrolyte showed serum sodium level as 128 mmol/litre. This disease can be understood as Samana Avruta Vyana in hyponatremic encephalopathy stage and the stage of myelinolysis can be understood as Sarvanga Vata with Kapha Avruta Udana and Vyana. After clinical evaluation, Avarana Chikitsa was started followed by Kevala Vatika Chikitsa and significant improvement was seen. Significant result was observed in subjective and objective parameters after the treatment. The patient was discharged with oral medications for 1 month.

scholarly journals A Rare Case of Central Pontine Myelinolysis in Overcorrection of Hyponatremia with Total Parenteral Nutrition in Pregnancy

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Kalyana C. Janga ◽  
Tazleem Khan ◽  
Ciril Khorolsky ◽  
Sheldon Greenberg ◽  
Priscilla Persaud
Keyword(s):  
Parenteral Nutrition ◽  
Total Parenteral Nutrition ◽  
Serum Sodium ◽  
Rare Case ◽  
Central Pontine Myelinolysis ◽  
Graph Representation ◽  
Radiological Findings ◽  
Complicated Case ◽  
Pontine Myelinolysis ◽  
Central Pontine

A 42-year-old high risk pregnant female presented with hyponatremia from multiple causes and was treated with total parenteral nutrition. She developed acute hypernatremia due to the stage of pregnancy and other comorbidities. All the mechanisms of hyponatremia and hypernatremia were summarized here in our case report. This case has picture (graph) representation of parameters that led to changes in serum sodium and radiological findings of central pontine myelinolysis on MRI. In conclusion we present a complicated case serum sodium changes during pregnancy and pathophysiological effects on serum sodium changes during pregnancy.

Ruptured intradiploic dermoid cyst into an extra dural hematoma in a traumatic brain injury patient

2014 ◽  
Vol 11 (2) ◽  
pp. 175-177
Author(s):  
Sudhansu Sekhar Mishra ◽  
Deepak Das ◽  
Srikanta Das ◽  
Souvagya Panigrahi
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Dermoid Cyst ◽  
Traumatic Brain Injury Patient ◽  
Injury Patient

The Use of Nasal Trumpet in a Traumatic Brain Injury Patient With Obstructive Sleep Apnea

PM&R ◽  
2009 ◽  
Vol 1 (10) ◽  
pp. 977-979 ◽  
Author(s):  
Jaspal R. Singh ◽  
Miriam Segal ◽  
Richard Malone ◽  
Mohammed Zubair
Keyword(s):  
Traumatic Brain Injury ◽  
Obstructive Sleep Apnea ◽  
Brain Injury ◽  
Sleep Apnea ◽  
Traumatic Brain Injury Patient ◽  
Obstructive Sleep ◽  
Injury Patient

scholarly journals A Case of Central Pontine Myelinolysis Caused by Hypophosphatemia Secondary to Refeeding Syndrome

2015 ◽  
Vol 7 (3) ◽  
pp. 196-203 ◽  
Author(s):  
Chikara Yamashita ◽  
Hiroshi Shigeto ◽  
Norihisa Maeda ◽  
Takako Torii ◽  
Yasumasa Ohyagi ◽  
...  
Keyword(s):  
Serum Sodium ◽  
Central Pontine Myelinolysis ◽  
Rapid Change ◽  
Serum Biochemistry ◽  
Refeeding Syndrome ◽  
Pontine Myelinolysis ◽  
History Of ◽  
Biochemistry Test ◽  
Magnetic Resonance Imaging Mri ◽  
Central Pontine

Central pontine myelinolysis (CPM), which was originally considered to be the result of rapid correction of chronic hyponatremia, is not necessarily accompanied by hyponatremia or drastic changes in serum sodium level. Here, we report a case of an anorexic 55-year-old male with a history of pharyngo-laryngo-esophagogastrectomy, initially hospitalized with status epilepticus. Although his consciousness gradually recovered as we were controlling his convulsion, it deteriorated again with new onset of anisocoria, and magnetic resonance imaging (MRI) at this point revealed CPM. Rapid change of serum sodium or osmolarity, which is often associated with CPM, had not been apparent throughout his hospitalization. Instead, a review of the serum biochemistry test results showed that serum phosphate had drastically declined the day before the MRI first detected CPM. In this case, we suspect that hypophosphatemia induced by refeeding syndrome greatly contributed to the occurrence of CPM.

scholarly journals Relowering of Serum Na for Osmotic Demyelinating Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
Hideomi Yamada ◽  
Koji Takano ◽  
Nobuhiro Ayuzawa ◽  
George Seki ◽  
Toshiro Fujita
Keyword(s):  
Serum Sodium ◽  
Central Pontine Myelinolysis ◽  
Supportive Therapy ◽  
Chronic Hyponatremia ◽  
Pontine Myelinolysis ◽  
Extreme Care ◽  
The Brain ◽  
Osmotic Demyelinating Syndrome ◽  
Central Pontine ◽  
Rapid Correction

We report a case in whom slow correction of hyponatremia (5 mmol/day for 3 days) induced central pontine myelinolysis (CPM). After the diagnosis was confirmed by imaging, we started to relower serum Na that completely recovered the sign and symptoms of CPM. Rapid correction of serum sodium is known to be associated with CPM. However, it may occur even after slow correction of hyponatremia. Currently, there is no standard therapy for CPM other than supportive therapy. Other therapy includes sterioid, plasmaphresis and IVIG, but these therapies have not been shown to be particularly effective. The pathophysiology of CPM is related to a relative dehydration of the brain during the correction of hyponatremia, resulting in cell death and demyelination, therefore gentle rehydration with lowering serum sodium may not be an unreasonable therapy. The present case provides supportive evidence that reinduction of hyponatremia is effective in treating CPM if started immediately after the diagnosis is suggested. The present case tells us that severe chronic hyponatremia must be managed with extreme care especially in patients with chronic debilitating illness and that relowering serum Na is a treatment of choice when CPM is suggested.

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