Abstract

Dr. Mudasir Ahmad Dar*, Dr. Omar Farooq, Dr. Sobia, Dr. Javed Chacho and Dr. Irfan Shah

ABSTRACT

80 year old male with underlying hypertension with recent history of chlorthalidone induced symptomatic hyponatremia (Na-103) was managed in peripheral hospital with 3% saline presented to our emergency department with sudden onset altered sensorium. On physical examination HR was 90 b/m and BP of 120/80. Baseline investigations were normal except serum sodium of 130 mmol/l but was rigid, mute and not moving any limb(Akinetic rigid state). Central pontine myelinosis was suspected and MRI brain(fig-1) was done which was normal. Patient was managed as case of central pontine myelinosis and repeat MRI brain(fig-2) was done after 2 weeks which was suggestive of pontine myelinosis.