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Have Central Pontine Myelinolysis From Rapid Sodium Correction. Abnormal Babinsky Reflex. Painful, Uncontrollable Tremors

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Posted on Wed, 26 Sep 2012
Question: I have been diagnosed with Central Pontine Myelinolysis from rapid sodium correction (16 points in 10 hours). I was diagnosed based on clinical symptoms. the MRI was done only one day after onset of symptoms so I was told that it was probably too early to see changes int eh MRI.

My brain is clear and I can think very clearly which is good but I cannot seem to communicate. It is as if I cannot get the words out of my mouth. I can write pretty well though. This is the only effective way I can communicate now. I have not been able to eat a lot of solid food because it hurts when I swallow so I have lost 10 pounds - and I am too skinny to begin with. I cannot walk very well and I think I am seeing things - like moving shapes and colors but that may be because I cannot control my left eye completely. It keeps going side to side.

I am most comfortable sitting in bed propped up with my computer on my lap but when I rest I bend my arms with my hands sort of up - like a praying manthis. I can just sit like this for hours. One doctor told me that I had an abnormal Babinsky reflex but I am not sure what that means.....something to do with my feet.

I am in a lot of pain and I have uncontrollable tremors. I really need advice. Nobody knows what to do with me

The only care I have has is at the institution where this has happened. Needless to say it is a bit awkward. All I know is what I need to do?
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Answered by Dr. Pratap Sanchetee (10 hours later)

Hi,

Thanks for posting your query.

I am sorry to hear about your problem. Yes, Central pontine myelinolysis (CPM) can occur with electrolyte imbalances, particularly sodium. Unfortunately there is no curative treatment of this condition.

In most of the cases it tends to improve with passage of time. You will be benefited with symptomatic and supportive treatment under guidance of your doctor. Semisolid diet will be better tolerated and evaluation by dieticians is in order. A speech therapist can be involved in management.

A repeat MRI will be of help in delineating extent of damage and can be done.

Babinsky reflex suggest damage to motor nerve fibers in brain stem and no separate or specific treatment is needed for it.

As the symptoms tend to improve with time, I suggest you to work closely with your neurologist for adequate treatment of your current symptoms. I will be available for assistance should you have other concerns bothering you during the treatment.

I wish you a safe recovery.

Dr. Pratap

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Pratap Sanchetee

Neurologist

Practicing since :1974

Answered : 125 Questions

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Have Central Pontine Myelinolysis From Rapid Sodium Correction. Abnormal Babinsky Reflex. Painful, Uncontrollable Tremors


Hi,

Thanks for posting your query.

I am sorry to hear about your problem. Yes, Central pontine myelinolysis (CPM) can occur with electrolyte imbalances, particularly sodium. Unfortunately there is no curative treatment of this condition.

In most of the cases it tends to improve with passage of time. You will be benefited with symptomatic and supportive treatment under guidance of your doctor. Semisolid diet will be better tolerated and evaluation by dieticians is in order. A speech therapist can be involved in management.

A repeat MRI will be of help in delineating extent of damage and can be done.

Babinsky reflex suggest damage to motor nerve fibers in brain stem and no separate or specific treatment is needed for it.

As the symptoms tend to improve with time, I suggest you to work closely with your neurologist for adequate treatment of your current symptoms. I will be available for assistance should you have other concerns bothering you during the treatment.

I wish you a safe recovery.

Dr. Pratap