Central Pontine Myelinolysis Diagnosed Two Months after Onset of Coma：A Case Report

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  • NAKAMURA Youko
    Department of Anesthesiology and Critical Care Medicine, Tokyo Medical and Dental University
  • FUKUI Kenichi
    Department of Anesthesiology and Critical Care Medicine, Tokyo Medical and Dental University
  • SHIOTA Nobuhiro
    Department of Anesthesiology and Critical Care Medicine, Tokyo Medical and Dental University
  • HARAMO Akihiro
    Department of Anesthesiology and Critical Care Medicine, Tokyo Medical and Dental University
  • ADACHI Yushi
    Department of Anesthesiology and Critical Care Medicine, Tokyo Medical and Dental University
  • NAKAZAWA Koichi
    Department of Anesthesiology and Critical Care Medicine, Tokyo Medical and Dental University

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  • 昏睡から2カ月後に橋中心髄鞘崩壊症の診断に至った1例

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<p>A 78-year-old male patient receiving chemotherapy for esophageal cancer suddenly lost consciousness and subsequent intensive care was initiated after resuscitation on hospital day 12. Laboratory examination showed an extreme hyperosmotic state (serum sodium concentration : 169 mEq/L, blood sugar level : 817 mg/dL). Serum osomolarity was corrected within 1 week ; however, the patient was still in coma and mechanical ventilation was required. CT demonstrated cerebral infarctions in the posterior lobes and electroencephalogram showed cortical activities. Two months later, the conscious level suddenly improved and spontaneous respiration was observed. MRI findings strongly suggested the development of central pontine myelinolysis. The patient underwent rehabilitation training and was finally moved to a neighboring hospital without mechanical ventilation on hospital day 126.</p>

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