Journal
JOURNAL OF CLINICAL NEUROSCIENCE
Volume 7, Issue 3, Pages 256-259Publisher
CHURCHILL LIVINGSTONE
DOI: 10.1054/jocn.1999.0192
Keywords
parkinsonism; hyponatremia; central pontine myelinolysis; extrapontine myelinolysis
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Parkinsonism has been rarely described following central pontine and extrapontine myelinolysis, We report a case of parkinsonism developing following rapid correction of hyponatremia with radiological evidence of central pontine myelinolysis and changes in the basal ganglia. A 56-year-old man developed drooling and bilateral hand tremors 3 weeks after correction of hyponatremia from 103 to 125 mmol/L over 14 h. He had a prominent 6 Hz resting tremor which worsened with action and mild cogwheel rigidity. Magnetic resonance imaging (MRI) showed changes consistent with central pontine myelinolysis and increased signal on T1-weighted images in the putamen bilaterally. His tremor responded well to L-dopa therapy. There have been several other cases of parkinsonism developing after central pontine/extrapontine myelinolysis. Increased signal in the basal ganglia on T1-weighted images has been described in another case of central pontine myelinolysis imaged about the same time after sodium correction as our case. (C) 2000 Harcourt Publishers Ltd.
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