Reversible parkinsonism in central pontine and extrapontine myelinolysis: A report of five cases from India and review of the literature
- Author:
Kamala Kant Bhoi
;
Alak Pandit
;
Gautam Guha
;
Punnabrata Barma, Amar Kumar Misra
;
Prabhat Kumar Garai
;
Shyamal Kumar Das
- Publication Type:Journal Article
- From:Neurology Asia
2007;12(1):101-109
- CountryMalaysia
- Language:English
-
Abstract:
Parkinsonism with or without dystonia has been rarely described following central pontine myelinolysis
and extrapontine myelinolysis. We report 5 cases of reversible parkinsonism and dystonia with
imaging evidences of central pontine myelinolysis and extrapontine myelinolysis associated with
hyponatremia from a center in Eastern India. Their presentations varied from mild masked facies to
extra pyramidal syndromes characterized by progressive supranuclear palsy like feature and marked
dystonia. Two cases presented with flaccid quadriplegia later evolved into spasticity and dystonia.
The cause of hyponatremia was due to vomiting in two, diuretic-induced, nutritional and psychogenic
polydipsia one each. The onset was acute in 4, and gradual in one from psychogenic polydipsia. They
responded well to gradual correction of electrolyte imbalance, dopaminergic and antidystonic agents
including botulinum toxin. The movement disorders of central pontine myelinolysis with extrapontine
myelinolysis represent a treatable manifestationof the osmotic demyelination syndrome and rewarding
result can be achieved.
- Full text:P020150828391235823281.pdf
