TY - JOUR
T1 - A case of central pontine myelinolysis caused by hypophosphatemia secondary to refeeding syndrome
AU - Yamashita, Chikara
AU - Shigeto, Hiroshi
AU - Maeda, Norihisa
AU - Torii, Takako
AU - Ohyagi, Yasumasa
AU - Kira, Jun Ichi
N1 - Publisher Copyright:
© 2015 S. Karger AG, Basel.
PY - 2015
Y1 - 2015
N2 - 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.
AB - 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.
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U2 - 10.1159/000440711
DO - 10.1159/000440711
M3 - Article
AN - SCOPUS:84974578381
VL - 7
SP - 196
EP - 203
JO - Case Reports in Neurology
JF - Case Reports in Neurology
SN - 1662-680X
IS - 3
ER -