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Revista Cubana de Medicina

On-line version ISSN 1561-302X

Abstract

FERNANDEZ CUE, Leda; MIRANDA HERNANDEZ, José Luis; GOMEZ VIERA, Nelson  and  VALHUERDI PORTO, Camelia. Osmotic demyelination pontine and extrapontine during complicated puerperium. Rev cubana med [online]. 2018, vol.57, n.3, pp. 32-37. ISSN 1561-302X.

Central pontine myelinolysis is a rare neurological disorder of unknown etiology. The most frequent cause is the treatment of hyponatremia when sodium levels rise too fast. The destruction of the myelin sheaths is the basic lesion, which affects part or the entire base of the protuberance symmetrically (pontine demyelination). Patients with this disease usually present subacute progressive tetraparesis accompanied by pseudobulbar paralysis with dysarthria and the inability to protrude their tongue. A study is presented with the objective of describing the behavior of a case of osmotic demyelination in a patient as part of complicated puerperium. This is a 33-year-old female patient, with complicated pregnancy, secondary to cesarean section due to fetal death, after which she is admitted to intensive care. After several hydroelectrolyte alterations, flaccid quadriplegia was detected, with Locked-in Syndrome, with neuroimaging diagnosis of osmotic demyelination, with a favorable evolution.

Keywords : Pontine myelinolysis; corrective hypernatremia; hyponatremia.

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