Central Pontine Myelinolysis Diagnosed Two Months after Onset of Coma：A Case Report

A 78-year-old male patient receiving chemotherapy for esophageal cancer suddenly lost consciousness and subsequent intensive care was initiated after resuscitation on hospital day 12. Laboratory examination showed an extreme hyperosmotic state (serum sodium concentration : 169 mEq/L, blood sugar lev...

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Bibliographic Details
Published inNihon Rinshō Masui Gakkai shi Vol. 36; no. 4; pp. 429 - 433
Main Authors NAKAMURA, Youko, FUKUI, Kenichi, SHIOTA, Nobuhiro, HARAMO, Akihiro, ADACHI, Yushi, NAKAZAWA, Koichi
Format Journal Article
LanguageJapanese
English
Published THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA 15.07.2016
Subjects
Central pontine myelinolysis
Chemotherapy
Hyperglycemia
Hypernatremia
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Summary:A 78-year-old male patient receiving chemotherapy for esophageal cancer suddenly lost consciousness and subsequent intensive care was initiated after resuscitation on hospital day 12. Laboratory examination showed an extreme hyperosmotic state (serum sodium concentration : 169 mEq/L, blood sugar level : 817 mg/dL). Serum osomolarity was corrected within 1 week ; however, the patient was still in coma and mechanical ventilation was required. CT demonstrated cerebral infarctions in the posterior lobes and electroencephalogram showed cortical activities. Two months later, the conscious level suddenly improved and spontaneous respiration was observed. MRI findings strongly suggested the development of central pontine myelinolysis. The patient underwent rehabilitation training and was finally moved to a neighboring hospital without mechanical ventilation on hospital day 126.
ISSN:0285-4945
1349-9149
DOI:10.2199/jjsca.36.429