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Case No. 561
2020-08-01~2020-08-31
출제자 : 강경미
Hit : 392
| Period | 2020-08-01~2020-08-31 |
|---|---|
| Diagnosis | Osmotic demyelination syndrome |
| Gender |
|
| Age | 42 |
| Clinical information | M/42 Altered mentality (1DA) 진단은? |
| Discussion | • Acute demyelination w/o severe inflammation • Rapid shifts in serum osmolality • Biphasic: initial seizure or altered mentaility, second deterioration (2-3 days after normonatremia) • Alcoholism, nutrition deficiency, etc Imaging (1 or 2 weeks behind Sx): symmetric • Central Pontine Myelinolysis, isolated CPM(50%) • Extrapontine Myelinolysis, exclusive EPM (20-25%) ; BG, hemispheric WM > thalami, LGB, cerebellum (MCP), midbrain • CPM+EPM: pathognomonic (30%) • DWI: most sensitive, may enhance |
| Correct answer |
Correct Answer
Semi-Correct Answer |