Pontine/extrapontine myelinolysis occurring in the setting of an eating disorder
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Osmotic demyelination disorder (ODD) refers to a disorder in which rapid shifts in plasma osmolarity result in disruption of central myelin and includes central pontine myelinolysis and extrapontine myelinolysis (EPM). We present a patient with an eating disorder who developed a severe movement disorder due to EPM. Although ODD has been reported in the presence of eating disorders,1–6 this association is not well recognized.
Case report.
The patient was a 44-year-old woman with a long history of weight-centered concerns. One week after she had embarked on a regimen of self-induced vomiting along with the use of laxatives and diuretics, her family noticed progressive confusion and somnolence, until she was found unresponsive on her bathroom floor. When she was taken to the emergency room, her serum sodium level was 115 mEq/L. After 2 days of fluid restriction (outpatient), her serum sodium level was …
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Clinical/Scientific Notes
Hypernatremia from a hunger strike as a cause of osmotic myelinolysisAnnette H.M. van der Helm-van Mil, Jeroen P.P. van Vugt, Gert Jan Lammers et al.Neurology, February 07, 2005 -
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