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Central Pontine Myelinolysis & Pontine Lesions After Rapid Correction of Hyponatremia:An MRI Study
Ann Neurol 27:61-66, Brunner,J.E.,et al, 1990
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Article Abstract
The rate at which profound hyponatremia should be corrected is the focus of a recent clinical debate.We prospectively studied neurological outcomes with serial magnetic resonance imaging in 13 hyponatremic subjects with serum sodium concentrations of less than 115 mmol/L(mean initial serum sodium concentration 103.7;range,93-113 mmol/L).All subjects were corrected to mildly hyponatremic levels at 24 hours and ultimately underwent an increase in serum sodium concentration of 25 mmol/L without development of hypernatremia.Magnetic resonance imaging revealed the development on pontine lesions(mean+/-SD,1.25+/-0.4 mmol/(L/hr)versus 0. 74+/-0.3 mmol/(L/hr);p<0.05).Initial sodium concentration was also significantly lower in the pontine lesion group(97.3+/-6.7 vs 105.6+/-5.2 mmol/L,p<0.05).We conclude that the correction rate of hyponatremia plays a significant role in the pathogenesis of pontine lesions in individuals with profound hyponatremia who undergo large increases in sodium concentration as a result of severe initial hyponatremia.
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central pontine myelinolysis
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MRI
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