{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:47:17Z","timestamp":1777312037233,"version":"3.51.4"},"reference-count":26,"publisher":"Hamad bin Khalifa University Press (HBKU Press)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022]]},"abstract":"\n Hypernatremia (serum sodium>160 meq\/L) present with diverse neurological manifestations, ranging from flaccid paralysis to impaired cognition, encephalopathy, and even deep coma. Osmotic demyelination refers to changes in brain cells because of an acute change in plasma osmolality. It is further divided into two types, i.e., central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM). Patients with EPM, besides spasticity, may also present with other movement disorders such as catatonia, parkinsonism, and dystonia. We present a case of a postpartum woman bought to the emergency department by her relatives in an unconscious state. In view of poor sensorium (Glasgow coma scale\u00a0<\u00a07), she was intubated and received mechanical ventilatory support. On admission, computed tomography ofthebrain was normal, and the patient was transferred to the intensive care unit (ICU) for further management. The preliminary work-up in the ICU showed hypernatremia (serum sodium of 182 mEq\/L) with hyper-osmolality (359 mOsm\/kgH\n 2<\/jats:sub>\n O). She was managed as per the ICU protocol for hypernatremia. During her ICU stay, her sensorium improved, but she developed flaccid paralysis and was quadriplegic. Thus, a tracheostomy was performed, and she was weaned from the ventilator. After ventilator weaning, she was transferred to the ward for further rehabilitation. During rehabilitation, the patient was able to sit and\n takefoodorally.To<\/jats:ext-link>\n date, only a few cases are reported in postpartum women with acute severe hypernatremia caused by high-grade fever and loss of body fluids leading to extra-pontine demyelination and flaccid paralysis. This case highlightsthat prompt recognition and appropriate intervention can improve the outcomes in these patients.\n <\/jats:p>","DOI":"10.5339\/qmj.2022.45","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T04:32:09Z","timestamp":1665981129000},"source":"Crossref","is-referenced-by-count":5,"title":["Postpartum Hypernatremia with Extrapontine Rhabdomyelinolysis: A Case Report"],"prefix":"10.5339","volume":"2022","author":[{"given":"Garima","family":"Choudhary","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology & Critical Care, AIIMS Jodhpur E-mail: faisal.qur.90@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faisal","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology & Critical Care, AIIMS Jodhpur E-mail: faisal.qur.90@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anka","family":"Arora","sequence":"additional","affiliation":[{"name":"Senior Resident, Department of Neurology, AIIMS Jodhpur"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikhil","family":"Kothari","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology & Critical Care, AIIMS Jodhpur E-mail: faisal.qur.90@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarbesh","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, AIIMS Jodhpur"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pradeep","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology & Critical Care, AIIMS Jodhpur E-mail: faisal.qur.90@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3277","reference":[{"issue":"31","key":"CIT0001","series-title":"Semin Neurol","first-page":"135","article-title":"Encephalopathies caused by electrolyte disorders","author":"Samuels\n\u00a0\nMA","year":"2011"},{"issue":"Suppl 3","key":"CIT0002","series-title":"J Neurol Neurosurg Psychiatry","first-page":"iii22","article-title":"Central pontine and extrapontine myelinolysis: the osmotic demyelination syndromes","volume":"75","author":"Martin\n\u00a0\nRJ","year":"2004"},{"issue":"116","key":"CIT0003","series-title":"Dtsch Arztebl Int","first-page":"600","article-title":"Central pontine myelinosis and osmotic demyelination syndrome","author":"Lambeck\n\u00a0\nJ","year":"2019"},{"issue":"14","key":"CIT0004","series-title":"J Pediatr Neurosci","first-page":"97","article-title":"Idiopathic central pontine and extrapontine myelinolysis in a child","author":"Kamath\n\u00a0\nM","year":"2019"},{"issue":"13","key":"CIT0005","series-title":"Electrolyte Blood Press","first-page":"30","article-title":"A case of osmotic demyelination presenting with severe hypernatremia","author":"Han\n\u00a0\nMJ","year":"2015"},{"issue":"34","key":"CIT0006","series-title":"AJNR Am J Neuroradiol","first-page":"2225","article-title":"Clinical semiology and neuroradiologic correlates of acute hypernatremic osmotic challenge in adults: a literature review","author":"Ismail\n\u00a0\nFY","year":"2013"},{"issue":"13","key":"CIT0007","series-title":"Cureus","first-page":"e20281","article-title":"Central pontine myelinolysis in pregnancy: A case of rare occurrence","author":"Khan\n\u00a0\nSU","year":"2021"},{"issue":"21","key":"CIT0008","series-title":"J Am Soc Nephrol","first-page":"570","article-title":"Systemic arterial vasodilation, vasopressin, and vasopressinase in pregnancy","author":"Schrier\n\u00a0\nRW","year":"2010"},{"issue":"291","key":"CIT0009","series-title":"J Neurol Sci","first-page":"5","article-title":"Seasonal postpartum hypernatremic encephalopathy with osmotic extrapontine myelinolysis and rhabdomyolysis","author":"Naik\n\u00a0\nKR","year":"2010"},{"issue":"61","key":"CIT0010","series-title":"Acta Neurobiol Exp (Wars)","first-page":"141","article-title":"MR imaging of seven presumed cases of central pontine and extrapontine myelinolysis","author":"Bekiesi\u00f1ska-Figatowska\n\u00a0\nM","year":"2001"},{"issue":"86","key":"CIT0011","series-title":"Mayo Clin Proc","first-page":"1063","article-title":"Clinical and radiologic correlations of central pontine myelinolysis syndrome","author":"Graff-Radford\n\u00a0\nJ","year":"2011"},{"issue":"2012","key":"CIT0012","series-title":"Case Rep Neurol Med","first-page":"704639","article-title":"Relowering of serum na for osmotic demyelinating syndrome","author":"Yamada\n\u00a0\nH","year":"2012"},{"issue":"50","key":"CIT0013","series-title":"Neurol India","first-page":"306","article-title":"\u201cWine Glass\u201d appearance: a unique MRI observation in a case of primary lateral sclerosis","author":"Kuruvilla\n\u00a0\nA","year":"2002"},{"issue":"31","key":"CIT0001","series-title":"Semin Neurol","first-page":"135","article-title":"Encephalopathies caused by electrolyte disorders","author":"Samuels\n\u00a0\nMA","year":"2011"},{"issue":"Suppl 3","key":"CIT0002","series-title":"J Neurol Neurosurg Psychiatry","first-page":"iii22","article-title":"Central pontine and extrapontine myelinolysis: the osmotic demyelination syndromes","volume":"75","author":"Martin\n\u00a0\nRJ","year":"2004"},{"issue":"116","key":"CIT0003","series-title":"Dtsch Arztebl Int","first-page":"600","article-title":"Central pontine myelinosis and osmotic demyelination syndrome","author":"Lambeck\n\u00a0\nJ","year":"2019"},{"issue":"14","key":"CIT0004","series-title":"J Pediatr Neurosci","first-page":"97","article-title":"Idiopathic central pontine and extrapontine myelinolysis in a child","author":"Kamath\n\u00a0\nM","year":"2019"},{"issue":"13","key":"CIT0005","series-title":"Electrolyte Blood Press","first-page":"30","article-title":"A case of osmotic demyelination presenting with severe hypernatremia","author":"Han\n\u00a0\nMJ","year":"2015"},{"issue":"34","key":"CIT0006","series-title":"AJNR Am J Neuroradiol","first-page":"2225","article-title":"Clinical semiology and neuroradiologic correlates of acute hypernatremic osmotic challenge in adults: a literature review","author":"Ismail\n\u00a0\nFY","year":"2013"},{"issue":"13","key":"CIT0007","series-title":"Cureus","first-page":"e20281","article-title":"Central pontine myelinolysis in pregnancy: A case of rare occurrence","author":"Khan\n\u00a0\nSU","year":"2021"},{"issue":"21","key":"CIT0008","series-title":"J Am Soc Nephrol","first-page":"570","article-title":"Systemic arterial vasodilation, vasopressin, and vasopressinase in pregnancy","author":"Schrier\n\u00a0\nRW","year":"2010"},{"issue":"291","key":"CIT0009","series-title":"J Neurol Sci","first-page":"5","article-title":"Seasonal postpartum hypernatremic encephalopathy with osmotic extrapontine myelinolysis and rhabdomyolysis","author":"Naik\n\u00a0\nKR","year":"2010"},{"issue":"61","key":"CIT0010","series-title":"Acta Neurobiol Exp (Wars)","first-page":"141","article-title":"MR imaging of seven presumed cases of central pontine and extrapontine myelinolysis","author":"Bekiesi\u00f1ska-Figatowska\n\u00a0\nM","year":"2001"},{"issue":"86","key":"CIT0011","series-title":"Mayo Clin Proc","first-page":"1063","article-title":"Clinical and radiologic correlations of central pontine myelinolysis syndrome","author":"Graff-Radford\n\u00a0\nJ","year":"2011"},{"issue":"2012","key":"CIT0012","series-title":"Case Rep Neurol Med","first-page":"704639","article-title":"Relowering of serum na for osmotic demyelinating syndrome","author":"Yamada\n\u00a0\nH","year":"2012"},{"issue":"50","key":"CIT0013","series-title":"Neurol India","first-page":"306","article-title":"\u201cWine Glass\u201d appearance: a unique MRI observation in a case of primary lateral sclerosis","author":"Kuruvilla\n\u00a0\nA","year":"2002"}],"container-title":["Qatar Medical Journal"],"original-title":[],"link":[{"URL":"https:\/\/www.qscience.com\/view\/journals\/qmj\/2022\/4\/article-45.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.qscience.com\/downloadpdf\/journals\/qmj\/2022\/4\/article-45.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.qscience.com\/downloadpdf\/journals\/qmj\/2022\/4\/article-45.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T17:10:15Z","timestamp":1777309815000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.qscience.com\/view\/journals\/qmj\/2022\/4\/article-45.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":26,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.5339\/qmj.2022.45","relation":{},"ISSN":["2227-0426"],"issn-type":[{"value":"2227-0426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022]]}}}