J Korean Geriatr Soc.  2005 Sep;9(3):236-238.

Asymptomatic Extrapontine Myelinolysis in Diabetic Woman

• Yun SH
• Kwon SB
• Jung S
• Seo HJ
• Hwang SH

Abstract

Osmotic myelinolysis syndrome in central nervous system is classified into central pontine myelinolysis(CPM) and extrapontine myelinolysis(EPM). The former can cause a spastic quadriplegia, pseudobulbar palsy, and varying degree of mental disorder, but the latter a movement disorder(tremor, dystonia, parkinsonism, and chorea, etc), behavior change(mood instability, personality change, agitated delirium, and disinhibition, etc), and cognitive dysfunction. Although a few cases of asymptomatic CPM have been reported, asymptomatic EPM were rare. A 67-year-old woman with diabetes mellitus and old cerebral infarction has suffered from the common bile duct stone. She had hyponatremia(Na=126mEq/L) on admission and was corrected rapidly. Incidental findings of her brain MRI showed EPM. We experienced a case of bilateral middle cerebellar peduncle myelinolysis incidentally without neurological presentations and report a rare case of asymptomatic EPM recoverd in diabetic woman after rapid correction of hyponatremia.

Keyword

Extrapontine myelinolysis; Asymptomatic; Central pontine myelinolysis; Cerebellar peduncle

MeSH Terms

Aged
Brain
Central Nervous System
Cerebral Infarction
Chorea
Common Bile Duct
Delirium
Diabetes Mellitus
Dihydroergotamine
Dystonia
Female
Humans
Hyponatremia
Incidental Findings
Magnetic Resonance Imaging
Mental Disorders
Myelinolysis, Central Pontine*
Parkinsonian Disorders
Pseudobulbar Palsy
Quadriplegia
Dihydroergotamine