Computed tomography in the diagnosis of Canavan's disease

✍ Scribed by Mary R. Andriola

• Publisher: John Wiley and Sons
• Year: 1982
• Tongue: English
• Weight: 244 KB
• Volume: 11
• Category: Article
• ISSN: 0364-5134
• DOI: 10.1002/ana.410110318

✦ Synopsis

the fourteenth hospital day. During days 7 to 14, the patient continued in normal sinus rhythm without any bradyrhythmias or tachyrhythmias. Blood pressure remained stable at approximately 140/80 without marked fluctuation. Respirations remained between 18 and 20, and forced vital capacity increased to approximately 3.5 liters. Lumbar and thoracic myelography were normal. The cerebrospinal fluid contained no cells, and spinal fluid protein had risen to 66 mg/dl. The electromyogram was normal except for an incomplete interference pattern in the left quadriceps muscle. Motor nerve conduction studies of the left peroneal and posterior tibia1 nerves revealed mild slowing at 39.2 and 37.4 m/sec, respectively. Left femoral motor nerve conduction was normal at 76.7 mlsec. Although prior to the development of hyponatremia the patient had received acetaminophen, which has been shown to enhance the sensitivity of toad bladder to the action of antidiuretic hormone [4], no cases of SIADH secondary to the antidiuretic action of this drug have been reported. After correction of hyponatremia the drug was readministered without reappearance of SIADH.

The absence of autonomic dysfunction in this patient suggests that factors besides abnormalities of afferent vagal inhibitory action may produce SIADH in GBS. Furthermore, the patient developed neither severe limb weakness nor sufficient paralysis of respiratory muscles to require tracheostomy or mechanical ventilation: severe hyponatremia occurred while he was still ambulatory and controlling his own diet and fluid intake [5].