J Korean Med Assoc.  2001 Dec;44(12):1329-1335. 10.5124/jkma.2001.44.12.1329.

Central Pontine and EXtrapontine Myelinolysis

• Kim BJ
• Lee DH

• KMID: 2347832
• DOI: http://doi.org/10.5124/jkma.2001.44.12.1329

Abstract

The knowledge about nutritional, toxic, and metabolic causes of dementia is particularly important, because they may be reversible. Central pontine myelinolysis(CPM) is one of these causes. CPM is a well known but rare metabolic disease of unknown etiology linked to overly aggressive correction of hyponatremia. We report a 74-year-old woman who developed disorientation, memory disturbance, and behavioral problem following intensive care unit management for pneumonia. Mini-mental status examination-Korean version(MMSE-K) study revealed severe cognitive dysfunction. Brain magnetic resonance imaging showed changes consistent with CPM and extrapontine myelinolysis. After supportive care, patient's clinical status was significantly improved. We suggest that a metabolic problem such as CPM should be considered in the diagnosis of acute or subacute cognitive deterioration in elderly patients.

Keyword

Central pontine myelinolysis; Extrapontine myelinolysis; Cognitive dysfunction; Dementia

MeSH Terms

Aged
Brain
Dementia
Diagnosis
Female
Humans
Hyponatremia
Intensive Care Units
Magnetic Resonance Imaging
Memory
Metabolic Diseases
Myelinolysis, Central Pontine*
Pneumonia
Problem Behavior