Servicios Personalizados
Revista
Articulo
Indicadores
Citado por SciELO
Accesos
Links relacionados
Similares en SciELO
Compartir
Ginecología y obstetricia de México
versión impresa ISSN 0300-9041
Resumen
RODRIGUEZ-PINTO, Fredlis; GARCIA-PARDO, Andrea; ARDILA-SIERRA, Adriana y CASTRO, Carlos Alberto. Extrapontine myelinolysis in a pregnant with hyperemesis and hyponatremia. A case report. Ginecol. obstet. Méx. [online]. 2020, vol.88, n.6, pp.394-401. Epub 20-Sep-2021. ISSN 0300-9041. https://doi.org/10.24245/gom.v88i6.3579.
BACKGROUND:
Extrapontine myelinolysis is part of the osmotic demyelination syndrome, being an acute non-inflammatory demyelinating disease caused by hyperosmotic stress that injures oligodendrocytes and causes myelin loss in regions of the central nervous system other than the pons of the brain stem. Primarily caused by a rapid sodium correction in patients with hyponatremia, in pregnant women its most frequent association is with hyperemesis gravidarum.
CLINICAL CASE:
A 32-year-old indigenous woman was referred to a university hospital of high complexity, in Bogotá, from a territory of the Colombian Amazon, within the framework of a new health care model, with a 15-week pregnancy, who had a convulsive episode, aphasia and oral automatism, and a recent history of hyperemesis gravidarum. Another history of hyperemesis and hyponatremia a month ago. Initially, eclampsia and neuroinfection were suspected, a rapid correction of sodium, anticonvulsant, remission and management in the intensive care unit was performed. MRI was compatible with extrapontin myelinolysis. After a month she returned to the territory of origin for rehabilitation. She had a home delivery at 38.3 weeks and went to the hospital for placental delivery.
CONCLUSION:
Extrapontin myelinolysis should be considered in the differential diagnosis between pregnancy with acute neurological symptoms conditions and a history of hyperemesis or hyponatremia. In case of a repeated history of acute hyponatremia in pregnant women with hyperemesis, chronicity should be considered. It is recommended to integrate university hospitals to rural territories to optimize the diagnosis and management of this type of cases.
Palabras llave : Extrapontine Myelinolysis; Brain Stem; Sodium; Pregnant women; Old Indegenous Woman; Colombian; Aphasia; Hyperemesis gravidarum; Hyponatremia; Eclampsia.