DOI: 10.36347/sjmcr.2024.v12i03.027

Pages: 342-344

Centro and extrapontine myelinolysis (MCP-MEP) or osmotic demyelination syndrome, is a demyelination of the central part of the protuberance and other extraprotuberance territories, the main predisposing factor being too rapid correction of severe hyponatremia. We report a case of osmotic demyelination syndrome in a 37-year-old patient, followed for acute adrenal insufficiency, complicated by three cardiorespiratory arrests, with recoveries after resuscitation measures, the evolution was marked by a neurological aggravation with confusion and generalised hypotonia and myoclonic seizures. The diagnosis of centropontine and extrapontine myelinolysis was confirmed by brain magnetic resonance imaging performed seven days after an initial scan, which showed no specific abnormalities. Rapid correction of hyponatremia was the main cause of this syndrome. The course of centropontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) is variable. Treatment is mainly preventive, based on careful correction of severe hyponatremia and the factors contributing to it.