Central Pontine Myelinolysis (CPM) in Pediatric Patient with Acute Liver Failure : A Case Report

Fatima Souhila Bouchama ^1,2,3 Siham Si Merabet ^1,2,3 Kamel Elhalimi ^1,2,4 Safia Zoubir ^1,5

¹Faculty of Medicine of Oran, University Oran 1, Oran, Algeria
²Research Laboratory in Pediatric Accidentology, University Oran 1, Oran, Algeria
³Pediatric Anesthesiology and Intensive Care Unit, Pediatric Etablissement Specialized Hospital of Canastel Oran, Oran, Algeria
⁴Pediatric Intensive Care Unit, University Hospital Center of Oran, Oran, Algeria
⁵Pediatric Emergency Department, University Hospital Center of Oran, Oran, Algeria

Background: Central pontine myelinolysis (CPM) is a demyelinating disorders of central nervous system, witch related essentially to the rapid correction of hyponatremia but it’s not the only causal agent of this neurological disorder.

Objective: We aimed to describe and to identify causal agent of this syndrome.

Methods: We reported a case of a 5 year-old child hospitalized in our pediatric hospital from 10 September to 15 December 2019 for ALF with SAM witch complicated with CPM

Observation: We recorded that our patient presented: seizure, headache and altered state of consciousness 2 weeks after hospitalized with denutrition despite enteral nutrition, a biological exam showed hyponatremia and hypokalemia witch has been slowly corrected, Brain magnetic resonance imaging showed CPM. Aquasi complete recovery was observed in our patient despite confirmed diagnosis of CPM with a severe initial neurological disorder.

Conclusion: Since hyponatremia was corrected slowly in this case report, hypokalemia and denutrition seem to be others predisposing metabolic factors. Therefore, rapid correction of hyponatremia is not the only causal agent of this syndrome