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KMID : 0361420140380050702
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Journal of Korean Academy of Rehabilitation Medicine
2014 Volume.38 No. 5 p.702 ~ p.706
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Locked-in Syndrome due to Central Pontine Myelinolysis: Case Report
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Sohn Min-Kyun
Nam Jin-Hee
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Abstract
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Central pontine myelinolysis (CPM) classically occurs in alcoholics, malnourished individuals, chronic liver diseases, and rapid correction of hyponatremia. This report presents locked-in syndrome due to CPM following rapid correction of hyponatremia. A 44-year-old male came to the hospital due to a short period of loss of consciousness. He was alert and had no focal neurological abnormalities at admission. The serum sodium concentration was 118 mEq/L and was corrected to 134 mEq/L in the first 18 hours. One week later, progressive weakness in limbs developed and he progressed to a complete quadriplegic state and bulbar palsy, with only eye blinking preserved. Brain magnetic resonance imaging revealed a characteristic hyperintense signal abnormality in both pons, so he was diagnosed to locked-in syndrome caused by CPM. The patient gradually improved following continuous intensive rehabilitation for more than 2 years. He was able to move all joint muscles against gravity in generally and he could gait under supervision.
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KEYWORD
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Central pontine myelinolysis, Quadriplegia, Recovery of function
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