Resolution of MRI Findings in Central Pontine Myelinosis Associated With Hypokalemia

We report a case of a 20-year-old African-American female, hospitalized and treated for hyperemesis gravidarum and hypokalemia with a normal serum sodium level. Two to 3days into her hospitalization, she developed urinary incontinence, weakness, and pain in her lower extremities. An MRI brain scan s...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of the medical sciences 2007-12, Vol.334 (6), p.490-492
Main Authors: Patel, Shomeet V., Parish, David C., Patel, Rajendrakumar M., Grimsley, Edwin W.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Brain - pathology
Central pontine myelinosis
Diagnosis, Differential
Endocrinopathies
Female
General aspects
Humans
Hyperemesis Gravidarum - blood
Hyperthyroidism
Hypokalemia
Hypokalemia - blood
Hypokalemia - complications
Magnetic Resonance Imaging
Medical sciences
Myelinolysis, Central Pontine - diagnosis
Myelinolysis, Central Pontine - etiology
Non tumoral diseases. Target tissue resistance. Benign neoplasms
Pregnancy
Pregnancy Complications - blood
Sodium - blood
Thyroid. Thyroid axis (diseases)
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We report a case of a 20-year-old African-American female, hospitalized and treated for hyperemesis gravidarum and hypokalemia with a normal serum sodium level. Two to 3days into her hospitalization, she developed urinary incontinence, weakness, and pain in her lower extremities. An MRI brain scan showed central pontine signal alteration, leading to a diagnosis of CPM. A 4-month follow-up MRI brain scan showed complete resolution of the central pontine signal, with symptomatic improvement manifested by resolution of urinary incontinence and increased strength. Our case describes CPM occurring secondary to hypokalemia, with resolution of characteristic MRI findings at follow-up. Sole hypokalemia-induced CPM is very rare. What makes our patient even more unique is the complete resolution of the central pontine lesion on follow-up MRI. The cause of this cannot be completely explained and warrants further study.
ISSN:0002-9629
1538-2990
DOI:10.1097/MAJ.0b013e318068b224