Sequential Evolution of Extrapontine and Pontine Myelinolysis: Role of Hypokalemia—A Case Report

Abstract

Osmotic demyelination syndrome due to rapid correction of hyponatremia may present with myelinolysis at pontine and/or extrapontine locations. Of late, the role of hypokalemia in increasing the risk for demyelination is being recognised. A 57-year-old man underwent surgery for cervical myelopathy. Postoperatively, he developed hyponatremia and hypokalemia and went on to develop seizures followed by “locked in state”. Magnetic resonance imaging (MRI) after 8 days revealed extensive extrapontine myelinolysis. The patient recovered well over 8 weeks. Sequential development of MRI lesions and their resolution has been discussed.

Keywords

osmotic demyelination - hyponatremia - hypokalemia

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