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Locked-in Syndrome due to Central Pontine Myelinolysis: Case Report.
[locked-in syndrome]
Central
pontine
myelinolysis
(
CPM
)
classically
occurs
in
alcoholics
,
malnourished
individuals
,
chronic
liver
diseases
,
and
rapid
correction
of
hyponatremia
.
This
report
presents
locked-
in
syndrome
due
to
CPM
following
rapid
correction
of
hyponatremia
.
A
44
-
year
-old
male
came
to
the
hospital
due
to
a
short
period
of
loss
of
consciousness
.
He
was
alert
and
had
no
focal
neurological
abnormalities
at
admission
.
The
serum
sodium
concentration
was
118
mEq
/
L
and
was
corrected
to
134
mEq
/
L
in
the
first
18
hours
.
One
week
later
,
progressive
weakness
in
limbs
developed
and
he
progressed
to
a
complete
quadriplegic
state
and
bulbar
palsy
,
with
only
eye
blinking
preserved
.
Brain
magnetic
resonance
imaging
revealed
a
characteristic
hyperintense
signal
abnormality
in
both
pons
,
so
he
was
diagnosed
to
locked-
in
syndrome
caused
by
CPM
.
The
patient
gradually
improved
following
continuous
intensive
rehabilitation
for
more
than
2
years
.
He
was
able
to
move
all
joint
muscles
against
gravity
in
generally
and
he
could
gait
under
supervision
.
Diseases
Validation
Diseases presenting
"progressive weakness in limbs"
symptom
locked-in syndrome
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