Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2019; 7(24): 4420-4425
Published online Dec 26, 2019. doi: 10.12998/wjcc.v7.i24.4420
Rehabilitation of anterior pituitary dysfunction combined with extrapontine myelinolysis: A case report
Ming-Xuan Yang, Xue-Nong Chen
Ming-Xuan Yang, Xue-Nong Chen, Department of Rehabilitation, Affiliated Hospital of Zunyi Medical University, Zunyi 563003, Guizhou Province, China
Author contributions: Yang MX collected the clinical data, analyzed the data, and wrote the paper; Chen XN revised the manuscript for intellectual content; Yang MX was a major contributor to the writing of the manuscript; Both authors approved the final version of the article to be published.
Informed consent statement: Informed consent was obtained from the patient for publication of this report and any accompanying images and anonymized clinical information in the journal.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xue-Nong Chen, BSc, Chief Doctor, Department of Rehabilitation, Affiliated Hospital of Zunyi Medical University, No. 113 Dalian Road, Zunyi 563003, Guizhou Province, China. ymx0019@sina.cn
Telephone: +86-15329926285
Received: September 16, 2019
Revised: November 22, 2019
Accepted: November 30, 2019
Published online: December 26, 2019
Abstract
BACKGROUND

Extramedullary myelinolysis is a rare demyelinating disease, often caused by rapid increases in serum sodium concentration in patients with hyponatremia. Clinical manifestations are neuropsychiatric symptoms, limb weakness, and dysarthria. Because of its poor prognosis and high disability rate, it poses a huge burden on the global economy, societies, and families. This article reports rehabilitation in a patient with pituitary dysfunction combined with extramedullary myelinolysis.

CASE SUMMARY

A 27-year-old Chinese man developed anorexia, vomiting, and limb weakness and was diagnosed with pituitary insufficiency. He had low serum sodium, slow movement, muscle weakness, and muscle tone abnormalities after sodium supplementation, involuntary limb shaking, ataxia, and dysarthria. According to the symptoms and signs and imaging reports, he was diagnosed with extramedullary myelinolysis. After treatment with hormone therapy and neurotrophic drugs, motor and speech function did not improve, so he was treated in the rehabilitation department for 4 wk. The patient’s physical status was improved substantially during his stay at the rehabilitation department.

CONCLUSION

Patients with extramedullary myelinolysis who actively participate in rehabilitation intervention can significantly improve their activities of daily living.

Keywords: Anterior pituitary dysfunction, Extrapontine myelinolysis, Rehabilitation, Motor function, Speech function, Case report

Core tip: Medical treatment of extramedullary myelinolysis is beneficial for alleviating development of the disease, but treatment of patients with motor dysfunction, dysarthria, and other complications is poor, leading to difficulties in patient daily living, self-care, and social activity. Active intervention in rehabilitation has a beneficial effect on patient functional recovery.