Skip to main content
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1989 May;52(5):675–677. doi: 10.1136/jnnp.52.5.675

Magnetic resonance imaging in central pontine myelinolysis.

P D Thompson 1, D Miller 1, R F Gledhill 1, M N Rossor 1
PMCID: PMC1032189  PMID: 2732743

Abstract

Magnetic resonance imaging (MRI) was performed in two patients in whom a clinical diagnosis of central pontine myelinolysis (CPM) had been made. MRI showed lesions in the pons in both cases about 2 years after the illness, at a time when the spastic quadriparesis and pseudobulbar palsy had recovered. The persisting abnormal signals in CPM are likely to be due to fibrillary gliosis. Persistence of lesions on MRI means that the diagnosis of CPM may be electively, after the acute illness has resolved.

Full text

PDF
675

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ADAMS R. D., VICTOR M., MANCALL E. L. Central pontine myelinolysis: a hitherto undescribed disease occurring in alcoholic and malnourished patients. AMA Arch Neurol Psychiatry. 1959 Feb;81(2):154–172. [PubMed] [Google Scholar]
  2. Anderson T. L., Moore R. A., Grinnell V. S., Itabashi H. H. Computerized tomography in central pontine myelinolysis. Neurology. 1979 Nov;29(11):1527–1530. doi: 10.1212/wnl.29.11.1527. [DOI] [PubMed] [Google Scholar]
  3. Bearcroft C. P., Metcalfe K., McCarthy M. I., Almond M. K., Chong M. S., Hitman G. A. Clinical heterogeneity of central pontine myelinolysis. Lancet. 1988 Sep 17;2(8612):688–688. doi: 10.1016/s0140-6736(88)90504-1. [DOI] [PubMed] [Google Scholar]
  4. Bottomley P. A., Hart H. R., Jr, Edelstein W. A., Schenck J. F., Smith L. S., Leue W. M., Mueller O. M., Redington R. W. Anatomy and metabolism of the normal human brain studied by magnetic resonance at 1.5 Tesla. Radiology. 1984 Feb;150(2):441–446. doi: 10.1148/radiology.150.2.6691099. [DOI] [PubMed] [Google Scholar]
  5. Brunner J. E., Redmond J. M., Haggar A. M., Elias S. B. Central pontine myelinolysis after rapid correction of hyponatremia: a magnetic resonance imaging study. Ann Neurol. 1988 Apr;23(4):389–391. doi: 10.1002/ana.410230413. [DOI] [PubMed] [Google Scholar]
  6. DeWitt L. D., Buonanno F. S., Kistler J. P., Zeffiro T., DeLaPaz R. L., Brady T. J., Rosen B. R., Pykett I. L. Central pontine myelinolysis: demonstration by nuclear magnetic resonance. Neurology. 1984 May;34(5):570–576. doi: 10.1212/wnl.34.5.570. [DOI] [PubMed] [Google Scholar]
  7. Dickoff D. J., Raps M., Yahr M. D. Striatal syndrome following hyponatremia and its rapid correction. A manifestation of extrapontine myelinolysis confirmed by magnetic resonance imaging. Arch Neurol. 1988 Jan;45(1):112–114. doi: 10.1001/archneur.1988.00520250122033. [DOI] [PubMed] [Google Scholar]
  8. Gerard E., Healy M. E., Hesselink J. R. MR demonstration of mesencephalic lesions in osmotic demyelination syndrome (central pontine myelinolysis). Neuroradiology. 1987;29(6):582–584. doi: 10.1007/BF00350448. [DOI] [PubMed] [Google Scholar]
  9. Hazratji S. M., Kim R. C., Lee S. H., Marasigan A. V. Evolution of pontine and extrapontine myelinolysis. J Comput Assist Tomogr. 1983 Apr;7(2):356–361. doi: 10.1097/00004728-198304000-00034. [DOI] [PubMed] [Google Scholar]
  10. Illowsky B. P., Laureno R. Encephalopathy and myelinolysis after rapid correction of hyponatraemia. Brain. 1987 Aug;110(Pt 4):855–867. doi: 10.1093/brain/110.4.855. [DOI] [PubMed] [Google Scholar]
  11. Ormerod I. E., Miller D. H., McDonald W. I., du Boulay E. P., Rudge P., Kendall B. E., Moseley I. F., Johnson G., Tofts P. S., Halliday A. M. The role of NMR imaging in the assessment of multiple sclerosis and isolated neurological lesions. A quantitative study. Brain. 1987 Dec;110(Pt 6):1579–1616. doi: 10.1093/brain/110.6.1579. [DOI] [PubMed] [Google Scholar]
  12. Price B. H., Mesulam M. M. Behavioral manifestations of central pontine myelinolysis. Arch Neurol. 1987 Jun;44(6):671–673. doi: 10.1001/archneur.1987.00520180085025. [DOI] [PubMed] [Google Scholar]
  13. Price D. B., Kramer J., Hotson G. C., Loh J. P. Central pontine myelinolysis: report of a case with distinctive appearance on MR imaging. AJNR Am J Neuroradiol. 1987 May-Jun;8(3):576–577. [PMC free article] [PubMed] [Google Scholar]
  14. Rosenbloom S., Buchholz D., Kumar A. J., Kaplan R. A., Moses H., 3rd, Rosenbaum A. E. Evolution of central pontine myelinolysis on CT. AJNR Am J Neuroradiol. 1984 Jan-Feb;5(1):110–112. [PMC free article] [PubMed] [Google Scholar]
  15. Schroth G. Clinical and CT confirmed recovery from central pontine myelinolysis. Neuroradiology. 1984;26(2):149–151. doi: 10.1007/BF00339865. [DOI] [PubMed] [Google Scholar]
  16. Steller U., Koschorek F., Strenge H. Cerebellar ataxia with recovery related to central pontine myelinolysis. J Neurol. 1988 Jul;235(6):379–381. doi: 10.1007/BF00314240. [DOI] [PubMed] [Google Scholar]
  17. Sterns R. H., Riggs J. E., Schochet S. S., Jr Osmotic demyelination syndrome following correction of hyponatremia. N Engl J Med. 1986 Jun 12;314(24):1535–1542. doi: 10.1056/NEJM198606123142402. [DOI] [PubMed] [Google Scholar]
  18. Sztencel J., Baleriaux D., Borenstein S., Brunko E., Zegers de Beyl D. Central pontine myelinolysis: correlation between CT and electrophysiologic data. AJNR Am J Neuroradiol. 1983 May-Jun;4(3):529–530. [PMC free article] [PubMed] [Google Scholar]
  19. Takeda K., Sakuta M., Saeki F. Central pontine myelinolysis diagnosed by magnetic resonance imaging. Ann Neurol. 1985 Mar;17(3):310–311. doi: 10.1002/ana.410170317. [DOI] [PubMed] [Google Scholar]
  20. Telfer R. B., Miller E. M. Central pontine myelinolysis following hyponatremia, demonstrated by computerized tomography. Ann Neurol. 1979 Nov;6(5):455–456. doi: 10.1002/ana.410060515. [DOI] [PubMed] [Google Scholar]
  21. Thompson A. J., Brown M. M., Swash M., Thakkar C., Scholtz C. Autopsy validation of MRI in central pontine myelinolysis. Neuroradiology. 1988;30(2):175–177. doi: 10.1007/BF00395621. [DOI] [PubMed] [Google Scholar]
  22. Thompson D. S., Hutton J. T., Stears J. C., Sung J. H., Norenberg M. Computerized tomography in the diagnosis of central and extrapontine myelinolysis. Arch Neurol. 1981 Apr;38(4):243–246. doi: 10.1001/archneur.1981.00510040069012. [DOI] [PubMed] [Google Scholar]
  23. Thompson P. D., Gledhill R. F., Quinn N. P., Rossor M. N., Stanley P., Coomes E. N. Neurological complications associated with parenteral treatment: central pontine myelinolysis and Wernicke's encephalopathy. Br Med J (Clin Res Ed) 1986 Mar 8;292(6521):684–685. doi: 10.1136/bmj.292.6521.684. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Tomlinson B. E., Pierides A. M., Bradley W. G. Central pontine myelinolysis. Two cases with associated electrolyte disturbance. Q J Med. 1976 Jul;45(179):373–386. [PubMed] [Google Scholar]
  25. Wright D. G., Laureno R., Victor M. Pontine and extrapontine myelinolysis. Brain. 1979 Jun;102(2):361–385. doi: 10.1093/brain/102.2.361. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES