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Neuropediatrics 2012; 43(03): 152-154
DOI: 10.1055/s-0032-1307458
Short Communication
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Centropontine Myelinolysis Related to Refeeding Syndrome in an Adolescent Suffering from Anorexia Nervosa

Sandrine Leroy
1   Department of Epidemiology of Emerging Diseases Unit, Insititut Pasteur, Paris, France
,
Ariel Gout
2   Department of Neuropediatrics, Bicetre Hospital, Paris, France
,
Beatrice Husson
3   Department of Pediatric Neurology, Bicêtre University Hospital, Le Kremlin Bicêtre, France
,
Renault de Tournemire
4   Department of Adolescent Medicine, Bicetre Hospital, Paris, France
,
Marc Tardieu
3   Department of Pediatric Neurology, Bicêtre University Hospital, Le Kremlin Bicêtre, France
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Publikationsverlauf

06. November 2011

01. Februar 2012

Publikationsdatum:
02. April 2012 (online)

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Abstract

Centropontine myelinolysis (CPM) is a rare neurologic disorder defined by symmetric demyelination in the central pons, mostly due to alcoholism, malnutrition, or water-electrolyte abnormalities. We report an unusual case of CPM likely due to hypophosphatemia, related to a refeeding syndrome in the context of mental anorexia. A 15-year-old girl with mental anorexia presented with hypophosphatemia in the following days of enteral refeeding, and then suffered from confusion, neurological signs, and typical MRI lesions of CPM. Hypophosphoremia may be considered as a causative agent in CPM related to refeeding syndrome. This clinical observation also highlights the importance of recognizing patients at high risk of refeeding syndrome to initiate a balanced nutrition with careful monitoring.

Keywords

central pontine myelinolysis - children - electrolyte - refeeding syndrome - mental anorexia
 

  • References

  • 1 Adams RD, Victor M, Mancall EL. Central pontine myelinolysis: a hitherto undescribed disease occurring in alcoholic and malnourished patients. AMA Arch Neurol Psychiatry 1959; 81 (2) 154-172
    CrossrefPubMedGoogle Scholar
  • 2 Lilje CG, Heinen F, Laubenberger J, Krug I, Brandis M. Benign course of central pontine myelinolysis in a patient with anorexia nervosa. Pediatr Neurol 2002; 27 (2) 132-135
    CrossrefPubMedGoogle Scholar
  • 3 Brito AR, Vasconcelos MM, Cruz Júnior LC , et al. Central pontine and extrapontine myelinolysis: report of a case with a tragic outcome. J Pediatr (Rio J) 2006; 82 (2) 157-160
    PubMedGoogle Scholar
  • 4 Falcone N, Compagnoni A, Meschini C, Perrone C, Nappo A. Central pontine myelinolysis induced by hypophosphatemia following Wernicke's encephalopathy. Neurol Sci 2004; 24 (6) 407-410
    CrossrefPubMedGoogle Scholar
  • 5 Kumar S, Fowler M, Gonzalez-Toledo E , et al. Central pontine myelinolysis, an update. Neurol Res 2006; 3: 360-366
    PubMedGoogle Scholar
  • 6 Melchior JC. From malnutrition to refeeding during anorexia nervosa. Curr Opin Clin Nutr Metab Care 1998; 1 (6) 481-485
    CrossrefPubMedGoogle Scholar
  • 7 Michell AW, Burn DJ, Reading PJ. Central pontine myelinolysis temporally related to hypophosphataemia. J Neurol Neurosurg Psychiatry 2003; 74 (6) 820-826
    CrossrefPubMedGoogle Scholar
  • 8 Patel AS, Matthews L, Bruce-Jones W. Central pontine myelinolysis as a complication of refeeding syndrome in a patient with anorexia nervosa. J Neuropsychiatry Clin Neurosci 2008; 20 (3) 371-373
    CrossrefPubMedGoogle Scholar
  • 9 Husein B, Iqbal J, Mohammed A, Shorrock C. Too much, too soon. Gut 2009; 58: 1575-1576
    CrossrefPubMedGoogle Scholar
  • 10 Sechi G, Serra A. Wernicke's encephalopathy: new clinical settings and recent advances in diagnosis and management. Lancet Neurol 2007; 6 (5) 442-455
    CrossrefPubMedGoogle Scholar