title: Central pontine and extrapontine myelinolysis associated with acute hepatic dysfunction.
abstract: Central pontine myelinolysis and extrapontine myelinolysis are rare demyelinating diseases of the central nervous system. These diseases are related frequently to rapid correction of hyponatremia. They have also been described in association with other underlying conditions such as alcoholism and malnutrition. In the present study, we report a case of central pontine and extrapontine myelinolysis with acute hepatic dysfunction. The patient had no apparent evidence of hyponatremia and no history of alcohol abuse. On admission, the patient was lethargic; dysphagia, dysarthria, and quadriplegia were noted. Laboratory examination showed significantly increased transaminase without hyponatremia. Magnetic resonance imaging revealed abnormal signal intensities in the pons and thalamus. Consciousness level and clinical symptoms improved gradually within a week. We suggest that acute hepatic dysfunction may play an important role in the development of central pontine myelinolysis and extrapontine myelinolysis.
authors.affiliation: Department of Neurology, China-Japan Union Hospital, Jilin University, Changchun, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Chang
authors.forename: Dong-Hong
authors.initials: DH
authors.lastname: An
authors.forename: Ying
authors.initials: Y
authors.lastname: Xing
authors.forename: Xin
authors.initials: X
authors.lastname: Qi
mesh_terms: D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008107:Liver Diseases / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D017590:Myelinolysis, Central Pontine / Q000209:etiology* / Q000473:pathology; D011149:Pons / Q000473:pathology*
references.citation: Acta Neurol Scand. 2001 Dec;104(6):385-8
references.pmid: 11903095
references.citation: Parkinsonism Relat Disord. 2006 Oct;12(7):462-4
references.pmid: 16731027
references.citation: Neurology. 1984 May;34(5):570-6
references.pmid: 6538649
references.citation: Metab Brain Dis. 2010 Mar;25(1):97-106
references.pmid: 20182780
references.citation: Eur Neurol. 2002;47(1):3-10
references.pmid: 11803185
references.citation: J Neurol Sci. 1998 Dec 11;161(2):173-5
references.pmid: 9879700
references.citation: Childs Nerv Syst. 1998 Apr-May;14(4-5):155-8
references.pmid: 9660114
references.citation: N Engl J Med. 1985 Oct 3;313(14):865-73
references.pmid: 2993889
references.citation: Radiology. 1988 Sep;168(3):795-802
references.pmid: 3406409
references.citation: AMA Arch Neurol Psychiatry. 1959 Feb;81(2):154-72
references.pmid: 13616772
references.citation: Am J Clin Pathol. 1966 Aug;46(2):239-44
references.pmid: 5912488
references.citation: Lancet. 1988 Jun 25;1(8600):1439-41
references.pmid: 2898591
references.citation: Intern Med. 2008;47(15):1425-30
references.pmid: 18670150
references.citation: AJNR Am J Neuroradiol. 2004 Feb;25(2):210-3
references.pmid: 14970019
references.citation: Am J Pathol. 2006 Apr;168(4):1169-78; quiz 1404-5
references.pmid: 16565492
references.citation: J Neurol Sci. 1976 Sep;29(1):65-81
references.pmid: 950576
references.citation: N Engl J Med. 1986 Jun 12;314(24):1535-42
references.pmid: 3713747
references.citation: Proc Natl Acad Sci U S A. 1982 Jul;79(14):4420-3
references.pmid: 6289301
references.citation: Dtsch Med Wochenschr. 1995 Mar 31;120(13):461
references.pmid: 7712937
references.citation: Exp Neurol. 2005 Mar;192(1):178-83
references.pmid: 15698632
references.citation: Brain. 1979 Jun;102(2):361-85
references.pmid: 455045
references.citation: AJNR Am J Neuroradiol. 1993 Jan-Feb;14(1):163-7
references.pmid: 8427080
references.citation: J Neuropathol Exp Neurol. 2006 Jan;65(1):1-11
references.pmid: 16410743
references.citation: Magn Reson Med. 1991 Aug;20(2):285-91
references.pmid: 1775053
references.citation: Clin Infect Dis. 2002 May 1;34 Suppl 2:S58-64
references.pmid: 11938498