Central Pontine Myelinolysis in a patient with a severe course of Covid-19. Case report

Abstract

The article presents the course of treatment and rehabilitation of a 73-years old Covid-19 patient with severe hyponatremia due to persistent vomiting and diarrhea. In spite of the restoration of the water-electrolyte balance, the patient continued to show consciousness disturbances, psychomotor retardation and mild tetraparesis. Those deficits were interpreted as symptoms of 'brain fog' in the course of Covid-19 as well as manifestation of critical condition polyneuropathy. It was laboratory diagnostics, performed after the patient's discharge from the hospital, that revealed central pontine myelinolysis sustained by the patient in the course of the infection. The article describes neuroimaging changes on magnetic resonance imaging diffusion weighted imaging (MRI DWI) characteristic of central pontine myelinolysis which is a rare disease. In addition, the article describes subsequent stages in working on the improvement of the patient's psychomotor abilities and in encouraging the doctor to rationally supplement sodium deficits, in compliance with the guidelines, as well as argues for continuing research into CNS impairment in the course of Covid-19.