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Case Reports in Neurological Medicine
Volume 2014, Article ID 745347, 5 pages
http://dx.doi.org/10.1155/2014/745347
Case Report

Central Pontine and Extrapontine Myelinolysis: The Great Masquerader—An Autopsy Case Report

1Department of Neurology, Vanderbilt University, Nashville, TN, USA
2Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
3Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

Received 9 December 2013; Accepted 30 December 2013; Published 4 March 2014

Academic Editors: G. Galassi, J. L. González-Gutiérrez, and M. Toft

Copyright © 2014 Sajish Jacob et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Central pontine myelinolysis is a demyelinating disorder characterized by the loss of myelin in the center of the basis pontis usually caused by rapid correction of chronic hyponatremia. The clinical features vary depending on the extent of involvement. Demyelination can occur outside the pons as well and diagnosis can be challenging if both pontine and extrapontine areas are involved. We herein report a case of myelinolysis involving pons, lateral geniculate bodies, subependymal region, and spinal cord. To the best of our knowledge, this case represents the second case of spinal cord involvement in osmotic demyelination syndrome and the first case of involvement of thoracic region of spinal cord.