| 나트륨 농도가 정상인 고혈당성 고삼투압 증후군환자에서 발생한 중심성 교뇌 수초용해 1예 |
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문현진, 박강서, 박찬웅, 김기방, 김용환, 류아정, 박세영 |
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| A Case of Central Pontine Myelinolysis Associated with Hyperglycemic Hyperosmolar Syndrome and Consistently Normal Serum Sodium |
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Hyun Jin Moon, Kang Seo Park, Chan Woong Park, Ki Bang Kim, Yong Hwan Kim, Ah Jeong Ryu, Se Young Park |
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| Abstract |
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Central pontine myelinolysis (CPM) is a demyelinating disorder that affects the pons and is characterized by disturbance of consciousness, quadriparesis and dysarthria. CPM may occur in a variety of clinical settings, but is particularly common following rapid correction of severe hyponatremia. CPM may develop as a result of rapid shifts in plasma osmolality during the treatment of hyperglycemic hyperosmolar syndrome (HHS) in some cases, but few reports have described HHS itself as a cause of CPM without rapid electrolyte correction. We present the case of a 62-year old man who presented to the emergency department with a history of unconsciousness for one day. His plasma glucose level was 1177 mg/dL and plasma sodium level was 124 mEq/L. Magnetic resonance imaging revealed a pontine lesion consistent with CPM. The patient received intensive treatment with intravenous insulin and 0.9% normal saline and made a gradual recovery over several weeks. In summary, we report a case of CPM without rapid electrolyte correction in a patient with HHS. (Korean Clinical Diabetes J 11:337-341, 2010) |
| Key Words:
Central pontine, Hyperglycemic hyperosmolar nonketotic coma, Myelinolysis |
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