A case of central pontine myelinolysis caused by hypophosphatemia secondary to refeeding syndrome

Chikara Yamashita, Hiroshi Shigeto, Norihisa Maeda, Takako Torii, Yasumasa Ohyagi, Jun Ichi Kira

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Central pontine myelinolysis (CPM), which was originally considered to be the result of rapid correction of chronic hyponatremia, is not necessarily accompanied by hyponatremia or drastic changes in serum sodium level. Here, we report a case of an anorexic 55-year-old male with a history of pharyngo-laryngo-esophagogastrectomy, initially hospitalized with status epilepticus. Although his consciousness gradually recovered as we were controlling his convulsion, it deteriorated again with new onset of anisocoria, and magnetic resonance imaging (MRI) at this point revealed CPM. Rapid change of serum sodium or osmolarity, which is often associated with CPM, had not been apparent throughout his hospitalization. Instead, a review of the serum biochemistry test results showed that serum phosphate had drastically declined the day before the MRI first detected CPM. In this case, we suspect that hypophosphatemia induced by refeeding syndrome greatly contributed to the occurrence of CPM.

Original languageEnglish
Pages (from-to)196-203
Number of pages8
JournalCase Reports in Neurology
Volume7
Issue number3
DOIs
Publication statusPublished - Jan 1 2015

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Refeeding Syndrome
Central Pontine Myelinolysis
Hypophosphatemia
Hyponatremia
Serum
Anisocoria
Sodium
Magnetic Resonance Imaging
Status Epilepticus
Consciousness
Biochemistry
Osmolar Concentration
Seizures
Hospitalization
Phosphates

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

A case of central pontine myelinolysis caused by hypophosphatemia secondary to refeeding syndrome. / Yamashita, Chikara; Shigeto, Hiroshi; Maeda, Norihisa; Torii, Takako; Ohyagi, Yasumasa; Kira, Jun Ichi.

In: Case Reports in Neurology, Vol. 7, No. 3, 01.01.2015, p. 196-203.

Research output: Contribution to journalArticle

Yamashita, Chikara ; Shigeto, Hiroshi ; Maeda, Norihisa ; Torii, Takako ; Ohyagi, Yasumasa ; Kira, Jun Ichi. / A case of central pontine myelinolysis caused by hypophosphatemia secondary to refeeding syndrome. In: Case Reports in Neurology. 2015 ; Vol. 7, No. 3. pp. 196-203.
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