Neuropsychological findings of extrapontine myelinolysis without central pontine myelinolysis.
Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are well recognized syndromes related to the rapid correction of hyponatremia, which are reported to show brain stem signs and various movement disorders. Cognitive dysfunction and neuropsychological findings, however, have seldom been reported. Cognitive manifestations in osmotic myelinolysis may have been underestimated due to the prominent brain stem symptoms and movement disorders. We report a case of EPM without CPM and describe the neuropsychological findings of EPM. The absence of CPM in this case made it possible to test neuropsychological function in the acute stage. Neuropsychological testing showed severe impairment of attention, verbal and visual memory, visuospatial function, and frontal/executive function. Language and language-related functions were normal except naming.
Seok
Jung Im
JI
Department of neurology, School of Medicine, Catholic University of Daegu, Korea. ji-helpgod@hanmail.net
Lee
Dong Kuck
DK
Kang
Min Gu
MG
Park
Jae Han
JH
D000368:Aged; D001288:Attention; D001480:Basal Ganglia Diseases / Q000150:complications / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D006801:Humans; D007010:Hyponatremia / Q000150:complications / Q000628:therapy; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis* / Q000209:etiology; D017590:Myelinolysis, Central Pontine / Q000145:classification / Q000209:etiology / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D009483:Neuropsychological Tests; D011149:Pons / Q000473:pathology; D016896:Treatment Outcome; D014705:Verbal Behavior