title: Extrapontine Myelinolysis in a patient with Primary Adrenal Insufficiency.
abstract: OBJECTIVE
  To report the development of estrapontine myelinolysis (EPM) in a patient with adrenal insufficiency and review similar in the literature.
  
  
  METHODS
  A 49-year-old female with insufficiency presented with acute dysarthria, stuttering, and parkinsonism. She received isotonic saline hydration for adrenal crisis and hyponatremia 18 days before the onset of symtoms. The brain MRI and MRS showed demyelination at bilateral basal ganglia and the thalamus, which was compatible with EPM and resolved within 3 months after steroid treatment.
  
  
  CONCLUSIONS
  Development of acute parkinsonism after rapid correction of hyponatremia may indicate the occurrence of EPM and underlying adrenal insufficiency should be excluded in these patients.
authors.forename: Jr-Wei
authors.initials: JW
authors.lastname: Wu
authors.forename: Pei-Ning
authors.initials: PN
authors.lastname: Wang
authors.forename: Jiing-Feng
authors.initials: JF
authors.lastname: Lirng
authors.forename: Ruei-Wen
authors.initials: RW
authors.lastname: Hsu
authors.forename: Wei-Ta
authors.initials: WT
authors.lastname: Chen
mesh_terms: D000309:Adrenal Insufficiency / Q000150:complications*; D005260:Female; D006801:Humans; D007010:Hyponatremia / Q000628:therapy; D009682:Magnetic Resonance Spectroscopy; D008875:Middle Aged; D017590:Myelinolysis, Central Pontine / Q000175:diagnosis / Q000209:etiology*; D020734:Parkinsonian Disorders / Q000209:etiology; D013577:Syndrome