The osmotic demyelination syndrome includes pontine and extrapontine myelinolysis, the first being its classic form of presentation. Usually related to rapid corrections of hyponatremia (serum sodium less than 135mEq/L), it has been described in multiple conditions that can alter plasma osmolality. The symptoms are varied and include spastic tetra paresis, pseudobulbar paralysis, coma, seizures or the characteristic “locked in” syndrome, as well as behavioral disorders such as lack of impulse control, aggressiveness, depressive syndromes, catatonia, mutism, and emotional lability. Years ago, it was a very difficult entity to diagnose, but with the introduction of magnetic resonance imaging, many oligosymptomatic or asymptomatic cases have been detected, although there is no known treatment, spontaneous recovery can occur.
ganglios basales
Neuroimagen en síndrome de desmielinización osmótica. Neuroimaging in asmotic demyelination syndrome
Intoxicación por Monóxido de Carbono, Presentación de un Caso.
A 35-year-old patient experienced 2 months, low levels of carbon monoxide exposure, produced by the motor of his vehicle. He experienced drowsiness in the morning. Because of drowsiness he had an automotomobile accident with traumatic brain injury. The only symptom at the time of neurological examination was anterograde amnesia. The magnetic resonance (MRI) of the brain revealed bilateral necrosis of the globus pallidus. We present this case for prevention of carbon monoxide poisoning and as an example of the utility of MRI and neuropsychological examinations in detecting central nervous system dysfunction secondary to CO exposure.
