Rapid Development of Central Pontine Myelinolysis after Recovery from Wernicke Encephalopathy: A Non-alcoholic Case without Hyponatremia
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概要
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We describe a non-alcoholic diabetic patient with central pontine myelinolysis (CPM) and Wernicke encephalopathy (WE). A 69-year-old man developed consciousness disturbance after parenteral hyperalimentation for liver abscess and sepsis. Neurological examination revealed drowsiness and no articulation. MRI disclosed T2-hyperintense lesions in the dorsal medulla oblongata and dentate nuclei, and symmetric enhancement in the inferior colliculus. Thiamine treatment (1,000 mg/day, div) attenuated neurological deficits. Seven days later, WE-related lesions were markedly regressed and a central pontine T2-hyperintensity lesion appeared. Serum sodium levels were normal. Physicians should pay more attention to rapid development of normonatremic CPM under thiamine supplementation in non-alcoholic WE patients.
著者
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Iwasaki Yasuo
Department Of Neurology Toho University Ohmori Hospital
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IKEDA Ken
Department of Cardiovascular and Respiratory Medicine, Akita University Graduate School of Medicine
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Murata Kiyoko
Department of Neurology, Toho University Omori Medical Center
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Hirayama Takehisa
Department of Neurology, Toho University Omori Medical Center
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Kawabe Kiyokazu
Department of Neurology, Oomori Hospital, Toho University
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Kishimoto Yuui
Department of Gastroenterology, Toho University Omori Medical Center, Japan
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