• PNF and Movement
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• v.12 no.4
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• pp.249-258
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• 2014

Purpose: This study examines deficits in upper-extremity function and trunk control ability on the osmotic demyelination syndrome of a patient with Hyponatremia and Hypokalemia. Using a proprioceptive neuromuscular facilitation program, this case report aims to describe the effects of trunk stability exercises on trunk control ability, hand function, and daily living activities as well as its effects on the osmotic demyelination syndrome of a patient with Hyponatremia and Hypokalemia. Methods: The patient is a 47-year-old woman with osmotic demyelination syndrome as well as trunk and upper extremity impairment. She participated in this training intervention for four weeks. Results: The patient demonstrated improvements in trunk control ability, hand function, and performance of ADL. The following outcomes were measured before and after the training program: trunk impairment scale, hand power, Jebsen-Taylor hand function test, the Chedoke arm and hand inventory, and the modified Barthel index. Conclusion: The results suggest that trunk stability exercises in the form of a proprioceptive neuromuscular facilitation program in Hyponatremia and Hypokalemia patients may increase trunk control ability, increase hand function, and improve ADL.

• Journal of Yeungnam Medical Science
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• v.30 no.1
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• pp.25-30
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• 2013

Hyponatremia, the most common electrolyte disorder, has been rarely reported as causing rhabdomyolysis. Osmotic demyelination syndrome (ODS), a demyelinating disease of the central pons and/or other areas of the brain, is infrequently reported as associated with rapid correction of hyponatremia. This paper reports a case of ODS after correction of severe hyponatremia complicated by rhabdomyolysis. A 47-year-old female with a history of chronic alcoholism presented herself at the hospital with altered consciousness after three days of nausea and vomiting. She was on a thiazide diuretic for essential hypertension. Her blood tests upon her hospital admission showed hyponatremia ($Na^+$ 98 mEq/L), hypokalemia ($K^+$ 3.0 mEq/L), and elevation of her serum creatine phosphokinase (3,370 IU/L) with an increase in her serum myoglobin level 11,267 ng/mL). She was treated with intravenous fluid therapy that included isotonic and hypertonic salines along with potassium chloride. She became more alert, and her neurological condition gradually improved after the first five days of her therapy. On the ninth day after her admission, she developed progressive quadiaresis associated with dysarthria, dysphagia, and dystonia despite the resolution of her hyponatremia. Magnetic resonance imaging of her brain on 16th day revealed symmetrical areas of signal hyperintensity in her central pons, basal ganglia, and precentral gyrus in T2-weighted images, which are consistent with ODS. Her neurological symptoms steadily improved after six weeks with only supportive treatment and rehabilitation.