Author(s)

Aboubacar Sidiki Fofana^1*, Magara Samaké^1,2, Sah dit Baba Coulibaly³, Seydou Sy^4,5, Atabième Kodio⁴, Moctar Coulibaly⁶, Christophe Bouaka⁷, Ghassan Alchahin⁷, Hermione Deudjeu Youmbissie⁸, Hamadoun Yattara^4,5, Nouhoum Coulibaly⁴, Saharé Fongoro^4,5

¹Nephrology Unit, Fousseyni Daou Hospital in Kayes, Kayes, Mali.
²National Center for Scientific and Technological Research (CNRST), Bamako, Mali.
³Nephrology Unit, Somino Dolo Hospital in Mopti, Mopti, Mali.
⁴Nephrology and Hemodialysis Department, University Teaching Hospital of Point-G, Bamako, Mali.
⁵Faculty of Medicine and Odontostomatology, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
⁶Nephrology Unit, Mali Gavardo Hospital, Bamako, Mali.
⁷Nephrology and Hemodialysis Department, Martigues Hospital, Martigues, France.
⁸Medical Imaging Department, Martigues Hospital, Martigues, France.

Introduction: Centropontine myelinolysis (CPM) is a rare pathology, a delayed neurological complication corresponding to massive demyelination of the protrusion. Its exact pathogenesis is poorly understood. Rapid correction of sodium hyponatremia has been implicated as a potent causative factor. We report a case of CPM despite a priori conservative correction of hyponatremia with a favorable course in a 61-year-old alcoholic-smoker diabetic. Case Presentation: A 61-year-old man with chronic alcoholism presented to the emergency department (D0) with physical asthenia and anorexia. He was treated for severe hyponatremia at 104 mmol/L by careful rehydration with saline before being transferred to a nephrological hospital. Magnetic resonance imaging (MRI) performed at D14 for locked-in syndrome showed osmotic demyelination syndrome (Figure 1). The evolution was favorable after 3 months of rehabilitation marked by a progressive and clear improvement of clinical signs. Conclusion: This observation suggests an evaluation of the benefit/risk ratio of the short-term prognosis of profound hyponatremia with that of the metabolic stress induced by a still too rapid correction. Particular attention should be paid to diabetic patients in the context of chronic alcoholism or nutritional deficiencies.

Centropontine Myelinolysis, Hyponatremia, Alcoholism

Fofana, A. , Samaké, M. , Coulibaly, S. , Sy, S. , Kodio, A. , Coulibaly, M. , Bouaka, C. , Alchahin, G. , Youmbissie, H. , Yattara, H. , Coulibaly, N. and Fongoro, S. (2022) Centropontine Myelinolysis after Conservative Correction of Hyponatremia: A Case Report and Review of Contributing Factors. Open Journal of Nephrology, 12, 187-194. doi: 10.4236/ojneph.2022.122018.