Clinical case of extrapontine myelinolysis of alimentary toxic origin
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Krivonozhkina PS, Poplavskaya OV, Poplavskaya AA, et al. [Clinical case of extrapontine myelinolysis of alimentary toxic origin]. Rossiiskii psikhiatricheskii zhurnal [Russian Journal of Psychiatry]. 2023;(3):41-47. Russian
Based on the clinical observation of a case of extrapontine myelinolysis in a psychiatric hospital patient with severe psychotic disorder, refusal to eat for delusional reasons, and a history of alcohol abuse, we submit a description of the clinical features and diagnosis of a rare case of extrapontine myelinolysis of alimentary-toxic origin. The patient's long-term abuse of alcohol-containing beverages of poor quality and lack of adequate nutrition have led to a multi-focal lesion of the central nervous system (pyramidal, extrapyramidal system, cerebellum, cerebral cortex) of alimentary-toxic origin. We arrived at the conclusion that cystic-glial changes in the corpus callosum were the outcome of central demyelination of the corpus callosum (or extrapontine myelinolysis). It is noted that the clinical alertness of psychiatrists and neurologists regarding extrapontine myelinolysis in cases of nutritional toxic disorders is extremely important for the timely diagnosis of this urgent condition.
Keywords osmotic demyelinating syndrome; demyelination; extrapontine myelinolysis; hypernatremia; organic delusional disorder; case study; clinical case
1. Likhachev SA, Astapenko AV, Naumenko DV, et al. [A case of central pontine and extrapontine myelinolysis]. Nevrologija i nejrohirurgija. Vostochnaja Evropa [Neurology and Neurosurgery. Eastern Europe]. 2021;11(3):430–1. (In Russ.) 2. Gorodnik GA, Jojua TV, Jojua AG. [Acute demyelinating syndrome. Clinical and laboratory features]. Voennaja i takticheskaja medicina, medicina neotlozhnyh sostojanij [Military and tactical medicine, emergency medicine]. 2022;3(6):45–9. (In Russ.) DOI: https://doi.org/10.55359/2782-3296.2022.71.38.015 3. Trofimova TN, Sofronov GA, Belyakov NA, Medvedev SV. [Radiation diagnosis of toxic lesions of the brain]. Luchevaja diagnostika i terapija [Radiation diagnosis and therapy]. 2011;1(2);37–46. (In Russ.) 4. Barhaghi K, Molchanova-Cook O, Rosenburg M, et al. Osmotic demyelination syndrome revisited: review with neuroimaging. J La State Med Soc. 2017;169(4):89–93. PMID: 28850553 5. Goroshchenko SA, Ivanov AYu, Rozhchenko LV, et al. [Extrapontine myelinolysis following an aneurysmal subarachnoid hemorrhage (case report and literature review)]. Zhurnal Voprosy Neirokhirurgii Im. NN Burdenko [Burdenko's Journal of Neurosurgery]. 2016;80(6):82–7. (In Russ.) DOI: https://doi.org/10.17116/neiro201680682-87 6. Ramazanov GR, Shevchenko EV, Kovaleva EA. [Osmotic demyelinating syndrome]. Zhurnal im. NV Sklifosovskogo “Neotlozhnaja medicinskaja pomoshh'” [Russian Sklifosovsky Journal “Emergency Medical Care”]. 2020;9(1):159–66. (In Russ.) DOI: https://doi.org/10.23934/2223-9022-2020-9-1-159-166 7. Reijnders TDY, Janssen WMT, Niamut SML, Kramer AB. Role of risk factors in developing osmotic demyelination syndrome during correction of hyponatremia: a case study. Cureus. 2020;12(1):e6547. DOI: https://doi.org/10.7759/cureus.6547 8. Damulin I, Strutsenko A, Bychenko V. [Central pontine myelinolysis]. Vrach [Doctor]. 2018;(1):29–32. (In Russ.) DOI: https://doi.org/10.29296/25877305-2018-01-07 9. Juergenson I, Zappini F, Fiaschi A, et al. Teaching neuroimages: neuroradiologic findings in pontine and extrapontine myelinolysis: clue for the pathogenesis? Neurology. 2012;78(1):e1–2. DOI: https://doi.org/10.1212/WNL.0b013e31823ed0b5 10. Lobzin SV, Golovkin VI, Efimov IM, et al. [Extrapontine myelinolysis: clinical and immunological features of one case]. Vestnik Severo-Zapadnogo gosudarstvennogo medicinskogo universiteta im. II Mechnikova [Herald of the Northwestern State Medical University named after I.I. Mechnikov]. 2017;9(2):117–20. (In Russ.) 11. Wagner J, Mueller-Schunk S, Schankin Ch. The Piglet Sign: MRI Findings in Central Pontine Myelinolysis. Clin Neuroradiol. 2016;18(3):191. DOI: https://doi.org/https://doi.org/10.1007/s00062-008-8025-5 12. Sheveleva EM., Zaslavsky LG, Kovelenov AG, Skornjakova EA. [Central pontine and extrapontine myelinolysis: literature review and own observation]. Uchenye zapiski SPbGMU im. akad. IP Pavlova [The Record of the IP Pavlov St. Petersburg State Medical University]. 2020;27(2):72–8. (In Russ.) DOI: https://doi.org/10.24884/1607-4181-2020-27-2-72-78 13. Dzhodzhua TV, Demina T.N, Dzhodzhua AG, Rynkova YaV. [Central extrapontine myelinolysis in a patient with intractable vomiting of pregnant women (a clinical case and a review of the literature)]. Mediko-social'nye problemy sem'i [Medical and social problems of family]. 2022;27(1):151–61. (In Russ.) 14. Terenin MA, Luchanova SG, Rykovsky DM. [Central pontine and extrapontine myelinolysis on the background of alcohol withdrawal and rapid correction of chronic hyponatremia associated with hypokalemia. The use of immunosuppressive therapy (a clinical case and a brief review of the literature)]. Voennaja medicina [Military Medicine]. 2022;1(62):111–23. (In Russ.) DOI: https://doi.org/10.51922/2074-5044.2022.1.111
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