A 53-year-old man with a 20-year history of alcohol use disorder presents with chronic symptomatic hyponatremia (Na+ 114 mEq/L). During hospitalization, his sodium is rapidly corrected to 132 mEq/L over 12 hours. Two days later, he develops dysarthria, dysphagia, and quadriparesis. Vital signs show BP 138/82, HR 88, RR 16, temperature 37.2°C. MRI reveals pontine hyperintensities on T2-weighted imaging. Cranial nerves II–XII remain intact. Which demyelinating condition best explains these findings?
- A)Central pontine myelinolysisGABARITO
- B)Transverse myelitis
- C)Multiple sclerosis
- D)Guillain Barré syndrome
- E)Acute disseminated encephalomyelitis
Explicação
Rapid correction of chronic hyponatremia can cause osmotic demyelination syndrome, classically centered in the pons. Delayed onset dysarthria, dysphagia, and quadriparesis after sodium overcorrection is a classic board presentation. Ver explicação completa e trilha adaptativa →