Reinduction of hyponatremia to treat central pontine myelinolysis

Abstract

A 76-year-old man developed general malaise and polyuria over a few days, and then became lethargic when he was brought into the hospital. He was oriented to self, but not to time or place. He had general motor weakness, but there was no laterality. Sensory disturbance was not noticed, except that he had been blind following a head injury 10 years ago. On admission, his serum sodium and potassium levels were 106 mEq/L and 3.6 mEq/L, and a CT scan of the brain demonstrated a large mass in the sella turcica extending anteriorly into the sphenoid sinus, which was accompanied with intratumoral bleeding. Under the diagnosis of pituitary apoplexy causing acute adrenocortical insufficiency, a series of treatments was started. Along with hormone replacement with 20 mg/day of …