Pontine and Extrapontine Myelinolysis: A Neurologic Disorder following Rapid Correction of Hyponatremia

@article{Karp1993PontineAE,
  title={Pontine and Extrapontine Myelinolysis: A Neurologic Disorder following Rapid Correction of Hyponatremia},
  author={B. Karp and R. Laureno},
  journal={Medicine},
  year={1993},
  volume={72},
  pages={359–373}
}
Neurologic disorders developing after correction of severe, symptomatic hyponatremia were studied in 14 patients. None had a hypoxic event or other identifiable cause for the neurologic illness. Neurologic deterioration began about 3 days after correction and often followed a period of improvement in hyponatremic encephalopathy. Although the symptoms were as mild as transient confusion in 1 patient, they were more severe in the others. Typically, spastic quadriparesis, pseudobulbar palsy, and… Expand
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References

Pontine and extrapontine myelinolysis.
TLDR
Clinically, the frequent occurrence of central pontine myelinolysis in a setting of severe metabolic derangement, particularly of the serum sodium, points in the same direction. Expand