Extrapontine myelinolysis with parkinsonism after rapid correction of hyponatremia: high cerebrospinal fluid level of homovanillic acid and successful dopaminergic treatment.
Extrapontine myelinolysis (EPM) is a demyelinating process of the brain. We report the case of an 11-year-old girl who developed EPM with parkinsonism. Magnetic resonance imaging revealed demyelinating patterns in the basal ganglia without central pontine lesions. The cerebrospinal fluid levels of homovanillic acid and 5-hydroxyindoleacetic acid were high at the time of onset and normalized upon complete recovery from extrapyramidal symptoms after a dopaminergic treatment. We speculated that demyelination of nerve fibers containing dopamine receptors in the striatum might be a main cause of these symptoms.
Nagamitsu
S
S
Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume City, Japan.
Matsuishi
T
T
Yamashita
Y
Y
Yamada
S
S
Kato
H
H
D000978:Antiparkinson Agents / Q000627:therapeutic use; D001479:Basal Ganglia / Q000473:pathology; D002648:Child; D005260:Female; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid*; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid*; D007010:Hyponatremia / Q000188:drug therapy; D007552:Isotonic Solutions / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D017590:Myelinolysis, Central Pontine / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000503:physiopathology; D020734:Parkinsonian Disorders / Q000134:cerebrospinal fluid* / Q000175:diagnosis / Q000188:drug therapy; D012965:Sodium Chloride / Q000627:therapeutic use
D000978:Antiparkinson Agents; D007552:Isotonic Solutions; D012965:Sodium Chloride; D006897:Hydroxyindoleacetic Acid; D006719:Homovanillic Acid