• Am J Emerg Med · Jun 2008

    Case Reports

    Extrapontine myelinolysis after correction of hyponatremia presenting as generalized tonic seizures.

    • Chih-Ming Lin and Helen L Po.
    • Department of Neurology, Mackay Memorial Hospital, Taipei, Taiwan.
    • Am J Emerg Med. 2008 Jun 1; 26 (5): 632.e5-6.

    AbstractCentral pontine myelinolysis and extrapontine myelinolysis are rare complications of rapid correction of chronic hyponatremia. Central pontine myelinolysis is more common and more predictable in presentation. Extrapontine myelinolysis' presenting symptoms vary and may be as general as lethargy or altered mood. We report experience with a patient who developed only extrapontine myelinolysis after rapid correction of severe hyponatremia associated with gastroenteritis. His presenting sign, generalized seizures, has not been previously reported. We summarize risk factors for myelinolysis, which may be more common than previously thought, as well as steps to minimize risk while managing vulnerable patients.

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