Central Pontine Myelinolysis after Liver Transplantation: is Sodium the Only Villain? Case Report

Abstract

The etiology of central pontine myelinolysis is multifactorial, and special attention should be given to the group of patients at greater risk, such as those with sudden changes in the plasma levels of sodium, liver transplantation, chronic alcoholics, and malnourished. It is important to recognize that osmotic demyelination can develop in patients with low, normal, or elevated plasma levels of sodium, indicating the contribution of other trigger factors.

Sodium-reduced continuous venovenous hemodiafiltration (CVVHDF) for the prevention of central pontine myelinolysis (CPM) in hyponatremic patients scheduled for orthotopic liver transplantation

“…Mortality rates of 50% in the first two weeks and 90% in 6 months have been reported [11,[14][15][16]. If patients survive, most have significant neurological deficits [17].…”

Hyperemesis Gravidarum, Wernicke’s Encephalopathy and Korsakoff Syndrome Looked through the Lens of Three Cases, Paper II

“…The pregnancy outcome was delivery of living infant at week 35 and mother was discharged in stable condition. Evidently, like our case intractable hyponatremia a treatable condition is reported in severe HG associated with or without WE and rapid correction of hyponatremia is often the leading cause of CPM [20,22,34].. Sodium and thiamine are interdependent and thiamine is involved in nerve impulse conduction and its uptake dependent upon sodium.…”

Probable Isolated Hypertensive Brainstem Encephalopathy Combined with Intracerebral Hemorrhage: a Case Report

“…Although the osmotic myelinolysis can be rarely occurred in normal sodium level, electrolyte imbalance is an important clue for diagnosis in the central osmotic myelinolysis (18,19). The patient in this case was normal serum sodium level.…”