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| 저나트륨 혈증의 급속교정후 일시적인 회복후에 발생한 삼투성 탈수초 증후군 (Initial Transient Neurologic Recovery Followed by Delayed Deterioration of Osmotic Demyelination Syndrome; -A Case Report-) |
| 문희식, 이명호, 민경환, 한상웅, 노우균, 박근태, 박동우, 이영주, 김호중 (Hee Sig Mun, Myong Ho Lee, Kyung Hwan Min, Sang Woong Han, Woo Kyoon Rho, Geun Tae Park, Dong Woo Park, Young Joo Lee and Ho Jung Kim) |
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| Abstract |
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In literatures, most of the studies of severe hyponatremia during or following its treatment has been concentrated with special references to the rate of correction and its neurologic outcomes. But, there is relatively few ones analyzing the diverse clinical manifestations of neurologic symptorns or complica- tions during the course of treating severe hyponatremia. We experienced a catastrophic course related to hyponatremia in a 51 year woman with severe rheumatoid arthritis, who underwent knee joint replacement, and this case revealed the initial transient neurologic recovery for 3 days by the initial rapid correction of hyponatremia, then followed by delayed deterioration of osmotic demyelination syndrome leading to locked-in syndrome. Reported cases with similar clinical course(biphasic course) in the world lituratures were reviewed with special interests in the initial maximum rate of correction of hyponatremia and radiologic findings. This review suggests that clinicians treating the patients with severe symptomatic hyponatremia should be aware of the possibility of delayed neurologic sequelae despite the recovery of neurologic status as well as the degree of hyponatremia in the early treatment course of hyponatremia. |
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