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KMID : 0391520160240010021
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Journal of the Korean Child Neurology Society
2016 Volume.24 No. 1 p.21 ~ p.24
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A Case of Extrapontine Myelinolysis Presented by Psychiatric Symptoms
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Ahn Bora-mi
Joh Hyun-Soo
You Su-Jeong
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Abstract
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Osmotic demyelination syndrome (ODS), especially extrapontine myelinolysis (EPM),
is a rare neurological disorder caused by damage to the myelin sheath of the brain.
We encountered a 24-year-old man with psychiatric symptoms who was diagnosed
with EPM following rapid correction of hyponatremia. Hyponatremia was induced
by primary polydipsia; the serum sodium concentration of the patient was 97 mEq/L.
Previous medical history included mental retardation and epilepsy after childhood.
His seizures had been well controlled with antiepileptic drugs for about 10 years.
After admission, he was administered intravenous 3% NaCl, which increased his
serum sodium concentration to 135 mEq/L over 6 days. After discharge, he complained
of general weakness, agitation and insomnia and was readmitted. Brain
magnetic resonance imaging showed symmetric T2 signal changes in the bilateral
caudate head, putamen, and sparing globus. He was diagnosed with EPM and
treated with diazepam and quetiapine, an atypical antipsychotic drug. Eight days
later, his symptoms had improved. This study describes a 24-year-old man with
psychiatric symptoms who was diagnosed with EPM caused by rapid correction of
hyponatremia.
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KEYWORD
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Extrapontine myelinolysis (EPM), Hyponatremia, Psychiatric, Osmotic
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