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Year : 2017  |  Volume : 14  |  Issue : 3  |  Page : 188-189

Postpartum hypernatremic encephalopathy with “Wine Glass Sign” on magnetic resonance imaging

1 Department of Neurology, Indraprastha Apollo Hospital, New Delhi, India
2 Department of Nephrology, Indraprastha Apollo Hospital, New Delhi, India
3 Department of Obstetrics and Gynaecology, Indraprastha Apollo Hospital, New Delhi, India
4 Internal Medicine, Ram Manohar Lohia Hospital, New Delhi, India

Correspondence Address:
Vinit Suri
Department of Neurology, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/am.am_3_17

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We report a 28-year-old postpartum female with acute delirium, agitation, confusion, visual hallucinations, and limb weakness. Investigations revealed severe hypernatremia, hyperuricemia, rhabdomyolysis, acute kidney injury, normal serum and urine osmolarity, normal urine spot sodium level, and normal serum antidiuretic hormone level. Magnetic resonance imaging of brain revealed hyperintensities in bilateral corticospinal tracts showing the classical “Wine Glass sign” suggesting hypernatremia-related osmotic demyelination. Patient improved with gradual correction of hypernatremia. We would like to highlight the importance of timely recognition and appropriate treatment of this rare condition which is potentially fatal and may also lead to severe permanent neurological deficits.

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