J Korean Soc Emerg Med.  2007 Apr;18(2):168-172.

A Case of Central Pontine Myelinolysis Presenting as Continuous Nausea in the 16th week of Pregnancy

• Kim SP
• Kim SJ
• Cho NS

Abstract

Central pontine myelinolysis (CPM) is a demyelinating disease of the pons often associated as well with the demyelination of extrapontine areas of the central nervous system. Although the etiology and pathogenesis are unclear, CPM is usually associated with states such as too rapid correction of hyponatremia, alcohol intoxication, malnutrition, liver disease, burn, cancer, addison's disease, dehydrated disease, and electrolyte imbalance. Clinical presentations are nonspecific but are typically characterized by confused mentation, bulbar or pseudobulbar palsy (dysarthria, dysphagia, tetraplegia), rock-in syndrome, and common symptoms such as lethargy and dysarthria. Brain magnetic resonance imaging(MRI) in CPM results in diffuse high signal intensity in the pons on T2-weighted images, and shows slightly decreased signal intensity and no enhancement in the central pons on T1-weighted images. We described a case of a 30-year-old woman presenting with continuous nausea and vomiting in the 16th week of pregnancy. In order to achieve early diagnosis of CPM, We recommend that emergency physicians should consider CPM during differential diagnosis. Prompt diagnosis and management of associated complications are essential for favorable clinical outcomes in CPM.

Keyword

Central pontine myelinolysis; Nausea and Vomiting

MeSH Terms

Addison Disease
Adult
Brain
Burns
Central Nervous System
Deglutition Disorders
Demyelinating Diseases
Diagnosis
Diagnosis, Differential
Dysarthria
Early Diagnosis
Emergencies
Female
Humans
Hyponatremia
Lethargy
Liver Diseases
Malnutrition
Myelinolysis, Central Pontine*
Nausea*
Pons
Pregnancy*
Pseudobulbar Palsy
Vomiting