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Central pontine myelinolysis

Demonstration by nuclear magnetic resonance

From the Neurology (Drs. DeWitt, Buonanno, Kistler, and Zeffiro) and Medical (Dr. Brady) Services and the Department of Radiology (Drs. Buonanno, DeLaPaz, Brady, Rosen, and Pykett), Massachusetts General Hospital, Boston, MA.

An alcoholic, hyponatremic woman developed central pontine myelinolysis (CPM) and improved from a decerebrate, comatose state to alertness and full ambulation. NMR, using inversion-recovery and spin-echo pulse sequences, was performed sequentially from 4 weeks to 8 months after onset of symptoms and revealed a well-defined lesion with prolonged relaxation times. The lesion was anatomically consistent with CPM and was initially also visualized by CT. NMR showed no definite temporal change in the qualitative appearance of the lesion until the 8-month scan; however, quantitatively, a reduction of relaxation times was noted with each serial study.

Address correspondence and reprint requests to Dr. Kistler, Massachusetts General Hospital, Stroke-Behavior Laboratory, Burnham 802, Boston, MA 02114.

This work was supported in part by Technicare Corporation, Solon, OH. Dr. Brady is the recipient of a Research Career Development Award, NCI, 1 KO4 CA00848-01.

Accepted for publication August 9, 1983.

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