Neurology: Case of the Month

Test Yourself — Patient 75

Extrapontine myelinolysis following rapid correction of iatrogenic hyponatremia

1. Which of the following is NOT a typical sign/symptom of hyponatremia?
   • [ A ] Vomiting
   • [ B ] Lethargy
   • [ C ] Myalgias
   • [ D ] Seizures
   • [ E ] All of the above may be seen in hyponatremia
2. Which of the following medications has NOT been associated with hyponatremia?
   • [ A ] Carbamazepine (Tegretol)
   • [ B ] Desmopressin (DDAVP)
   • [ C ] Thiazide diuretics
   • [ D ] Cyclophosphamide
   • [ E ] All of the above have been associated with hyponatremia
3. Which of the following conditions would be expected to place a patient at the greatest degree of risk for development of osmotic demyelination?
   • [ A ] Widespread third degree burns
   • [ B ] Hashimoto's thyroiditis
   • [ C ] Multiple sclerosis
   • [ D ] Chronic inflammatory demyelinating polyneuropathy (CIDP)
   • [ E ] Sarcoidosis
4. Demyelination in which of the following structures would be LEAST common with extrapontine myelinolysis?
   • [ A ] Internal capsule
   • [ B ] Cerebellum
   • [ C ] Mamillary bodies
   • [ D ] Globus pallidus
   • [ E ] Frontal cortex

 

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