Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Preoperative Extrapontine Myelinolysis with Good Outcome in a Patient with Pituitary Adenoma

  • Zhou, Ying (Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences) ;
  • Zhu, Yicheng (Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences) ;
  • Wang, Wenze (Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences) ;
  • Xing, Bing (Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences)
  • Received : 2014.08.21
  • Accepted : 2015.02.23
  • Published : 2016.03.01
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Abstract

Few preoperative extrapontine myelinolysis (EPM) cases with pituitary adenoma have been reported. No such case had long follow-up to see the outcome of EPM. We reported a 38-year-old man complaining of nausea, malaise and transient loss of consciousness who was found to have severe hyponatremia. Neurologic deficits including altered mental status, behavioral disturbances, dysarthria and dysphagia developed despite slow correction of hyponatremia. Endocrine and imaging studies revealed hypopituitarism, nonfunctional pituitary macroadenoma and extrapontine myelinolysis. Transsphenoidal surgery was performed after three weeks of supportive therapy, when neurological symptoms improved significantly. The patient recovered function completely 3 months after surgery. Our case indicates that outcome of EPM can be good even with prolonged periods of severe neurologic impairment.

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References

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