Document Type
Article
Publication Date
4-15-2018
Identifier
DOI: 10.1177/2329048X18770576; PMCID: PMC5903026
Abstract
An 11-month-old male presented with acute gastroenteritis, seizures, and altered mental status. Laboratory workup revealed serum sodium of 177 mmol/L. Magnetic resonance imaging of the brain showed reduced diffusion in the supratentorial white matter, T2 hyperintensities in the left central pons and midbrain, subacute stroke in the right occipital lobe, and bilateral cerebellar hemorrhagic infarcts. The child was presumed to have hypernatremia-induced central pontine and extrapontine myelinolysis. He received 5 days of high-dose methylprednisolone for persistent encephalopathy and spastic quadriparesis with rapid recovery of his cognitive function and neurological examination. The child remained seizure-free and achieved normal development at 3-month and 2-year follow-ups. Osmotic demyelination of infancy may leave children with a significant neurological deficit. For favorable neurological outcome, early steroids should be considered.
Journal Title
Child Neurol Open
Volume
5
Keywords
central pontine myelinolysis; extrapontine myelinolysis; methylprednisolone
Recommended Citation
Bansal LR. Therapeutic Effect of Steroids in Osmotic Demyelination of Infancy. Child Neurol Open. 2018;5:2329048X18770576. Published 2018 Apr 15. doi:10.1177/2329048X18770576
Comments
This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Publisher's Link: https://doi.org/10.1177%2F2329048X18770576