Pontine myelinolysis and delayed encephalopathy following the rapid correction of acute hyponatremia
J. D. Weissman and B. M. Weissman
Department of Neurology, University Hospitals of Cleveland, Ohio.
We describe a case of pontine myelinolysis associated with hyponatremia and
hyperammonemia resulting from bladder irrigation during a transurethral
prostatic resection. Following the procedure the patient exhibited
seizurelike activity. He underwent rapid correction of the hyponatremia, he
initially recovered but developed encephalopathy 19 days later. Magnetic
resonance images showed symmetrical lesions in the white matter of the
cerebellar peduncles. A relatively small pontine lesion was also noted. The
patient later recovered. This case demonstrates that myelinolysis
associated with rapid correction of hyponatremia may be greater in the
cerebellar peduncles than in the central pons.