A Case of Extrapontine Myelinolysis Without Central Pontine Myelinolysis Following Hyponatremia

Central pontine myelinolysis (CPM) is characterized by regions of demyelination throughout the brain but most prominent in the pons. The symptoms of CPM include rapidly evolving quadriplegia, pseudobulbar palsy and varying degree of altered consciousness. The exact pathogenesis is unknown. We report a rare case of extrapontine myelinolysis (EPM) without CPM; A 49-year-old man with chronic alcoholism and chronic type B hepatitis were presented with clinical symptoms of rapidly progressive quadriplegia and pseudobulbar palsy preeded by hyponatremia. Magnetic resonance imaging in this patient showed bilateral increased T2-weighted signals in the caudate nucleus and the putamen.