Document Detail


Central pontine and extrapontine myelinolysis that developed during alcohol withdrawal, without hyponatremia, in a chronic alcoholic.
MedLine Citation:
PMID:  20228603     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are osmotic demyelination syndrome. A 45-year-old man with a history of alcoholism visited the ER with dysarthria and dysphagia for 2 days. These symptoms occurred 3 days after he had stopped drinking alcohol. The neurological symptoms progressed to anarthria, pseudobulbar palsy and gait disturbance. During admission, the electrolyte studies were within the normal range. Diffusion-weighted images revealed high signal intensities in the pons, thalamus and basal ganglia. Apparent diffusion coefficient image showed low signal intensities in the pontine lesion, but isosignal intensities in the extrapontine lesion. The symptoms gradually improved after 1 month with only conservative treatment. The 1 month-follow-up MRI showed significant reduction of the previous extrapontine lesions. These findings suggest that cytotoxic edema is central to the pathogenesis of CPM, but vasogenic edema plays an important role in the pathogenesis of EPM occurring during alcohol withdrawal.
Authors:
Jae Young An; Sung Kyung Park; Si Ryung Han; In Uk Song
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-03-15
Journal Detail:
Title:  Internal medicine (Tokyo, Japan)     Volume:  49     ISSN:  1349-7235     ISO Abbreviation:  Intern. Med.     Publication Date:  2010  
Date Detail:
Created Date:  2010-03-15     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204241     Medline TA:  Intern Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  615-8     Citation Subset:  IM    
Affiliation:
Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea. nrjyan@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Alcoholism / complications*,  therapy
Edema / complications
Ethanol / adverse effects*
Humans
Male
Middle Aged
Myelinolysis, Central Pontine / diagnosis,  etiology*
Prognosis
Substance Withdrawal Syndrome / complications*
Chemical
Reg. No./Substance:
64-17-5/Ethanol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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