Naik Karkal Ravishankar, Saroja Aralikatte Onkarappa, Narayanappa Gayatri
Department of Neurology, KLE University's Jawaharlal Nehru Medical College and KLES Dr. Prabhakar Kore Hospital and MRC, Belgaum, Karnataka, India.
Ann Indian Acad Neurol. 2013 Oct;16(4):664-7. doi: 10.4103/0972-2327.120485.
Rhabdomyolysis results from many causes including hypernatremia. Postpartum hypernatremia with osmotic cerebral demyelination is a rare cause of reversible rhabdomyolysis. Electromyographic studies in postpartum hypernatremia have not been reported.
Electromyography (EMG) was performed in five women with postpartum hypernatremia and muscle biopsy was performed in one of them.
Among the five women presenting with postpartum hypernatremia associated with marked elevation of serum creatine kinase, four had quadriparesis. All had varying degrees of encephalopathy at admission and recovered without residual deficits after gradual correction of hypernatremia. Needle EMG revealed fibrillations with positive sharp waves in five patients and myotonic discharges in three patients. Serial EMG in one patient revealed the occurrence of transient fibrillations, positive sharp waves and myotonic discharges. Muscle biopsy revealed extensive rhabdomyolysis in one patient.
EMG in hypernatremic rhabdomyolysis revealed spontaneous activity including fibrillations, positive sharp waves and myotonic discharges along with myopathic potentials. Electromyographic findings depend on the interval from the onset and the degree of rhabdomyolysis.
横纹肌溶解症由多种原因引起，包括高钠血症。产后高钠血症伴渗透性脑脱髓鞘是可逆性横纹肌溶解症的罕见病因。产后高钠血症的肌电图研究尚未见报道。
对5例产后高钠血症患者进行了肌电图（EMG）检查，其中1例进行了肌肉活检。
在5例伴有血清肌酸激酶显著升高的产后高钠血症女性中，4例出现四肢瘫。所有患者入院时均有不同程度的脑病，在高钠血症逐渐纠正后均康复且无残留缺陷。针极肌电图显示5例患者有纤颤电位伴正锐波，3例患者有肌强直放电。1例患者的系列肌电图显示出现短暂的纤颤电位、正锐波和肌强直放电。肌肉活检显示1例患者有广泛的横纹肌溶解。
高钠血症性横纹肌溶解症的肌电图显示有自发活动，包括纤颤电位、正锐波和肌强直放电以及肌病性电位。肌电图表现取决于发病后的时间间隔和横纹肌溶解的程度。
