Extrapontine Myelinolysis in an 18-Month-Old Boy With Diabetic Ketoacidosis: Case Report and Literature Review

Gencpinar P., Tekguc H., ŞENOL A. U., DUMAN Ö., DURSUN O.

JOURNAL OF CHILD NEUROLOGY, vol.29, no.11, pp.1548-1553, 2014 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 29 Issue: 11
  • Publication Date: 2014
  • Doi Number: 10.1177/0883073813520496
  • Journal Name: JOURNAL OF CHILD NEUROLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.1548-1553
  • Keywords: extrapontine myelinolysis, children, diabetic ketoacidosis, CENTRAL PONTINE MYELINOLYSIS, OSMOTIC DEMYELINATION SYNDROME, RAPID CORRECTION, CHILD, HYPONATREMIA, OVERCORRECTION, MINOCYCLINE, 4-YEAR-OLD, EDEMA, DDAVP
  • Akdeniz University Affiliated: Yes

Abstract

Extrapontine myelinolysis is characterized by symmetric demyelination following rapid shifts in serum osmolality in the supratentorial compartment. Extrapontine myelinolysis in children is rare compared to adults. The most common underlying pathophysiology is rapid correction of hyponatremia. Only 2 cases were published after diabetic ketoacidosis without electrolyte imbalance in the English literature. This study presents an unusual and possibly the youngest case of extrapontine myelinolysis that occurred in the setting of diabetic ketoacidosis and complicated cerebral edema without electrolyte imbalance, along with a review of the literature.