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Central pontine myelinolysis: A case report and clinical–pathological review
Author(s) -
Cui Rosa,
Fayek Sameh,
Rand Elizabeth B.,
Feygin Tamara,
Khrichenko Dmitry,
Shaked Abraham
Publication year - 2012
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2011.01591.x
Subject(s) - central pontine myelinolysis , medicine , tacrolimus , immunosuppression , neurotoxicity , pathological , liver transplantation , magnetic resonance imaging , spastic quadriplegia , transplantation , pediatrics , surgery , cerebral palsy , toxicity , radiology , psychiatry
Cui R, Fayek S, Rand EB, Feygin T, Khrichenko D, Shaked A. Central pontine myelinolysis: A case report and clinical–pathological review. Pediatr Transplantation 2011. © 2011 John Wiley & Sons A/S. Abstract: An 11‐yr‐old child presented with acute mental status changes and spastic quadriplegia after orthotopic liver transplantation. Magnetic resonance (MR) imaging findings were consistent with central pontine and EPM. Initial immunosuppression included tacrolimus, mycophenolate mofetil, and corticosteroids. Given that neurotoxicity is a well‐established side effect of CNI, the patient was converted to rapamycin and subsequently experienced significant neurologic recovery. The temporal resolution of the patient’s symptoms suggests that prompt recognition of central pontine and EPM and conversion from tacrolimus to rapamycin during the early post‐operative course may have therapeutic benefits for patients undergoing pediatric transplant with CNI‐related neurotoxicity.