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Karki S, Agrawal S, Parajuli A, Ojha R, Gajurel BP, Karn R, Rajbhandari R, Gautam N, Paudel S, Shrestha A. Isolated extrapontine myelinolysis with neuropsychiatric manifestation: A case report from Nepal. SAGE Open Med Case Rep 2021; 9:2050313X211035572. [PMID: 34377483 PMCID: PMC8323443 DOI: 10.1177/2050313x211035572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 07/08/2021] [Indexed: 11/29/2022] Open
Abstract
A referred case of a 34-year-old woman was brought to the emergency room with features of
mutism and whole-body rigidity following rapid correction of hyponatremia. On
presentation, she was ill looking with tremors on her both hands and legs. She was
unresponsive to command and developed involuntary outbursts of laughter and crying. Based
on clinical features and neuroimaging, diagnosis of isolated extrapontine myelinolysis was
made. She was treated with quetiapine, vitamin B1 and B12
supplements, trihexyphenidyl, levodopa-carbidopa and physiotherapy of limbs. Due to lack
of clinical trials for adequate diagnosis and management of extrapontine myelinolysis,
this case report highlights the importance of extrapontine myelinolysis with
neuropsychiatric manifestation in research world.
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Affiliation(s)
- Susmin Karki
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Saurav Agrawal
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Asmita Parajuli
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Rajeev Ojha
- Department of Neurology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Bikram Prasad Gajurel
- Department of Neurology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Ragesh Karn
- Department of Neurology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Reema Rajbhandari
- Department of Neurology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Niraj Gautam
- Department of Neurology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Sunanda Paudel
- Department of Neurology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Aashish Shrestha
- Department of Neurology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
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