Go Back Brain/13. Brain and meninges, Supratentorial/Metabolic, Endocrine, Toxic/13.5 - Osmotic demyelination/ Go to Index

Central Pontine Myelinolysis

Acute demyelination affecting brainstem

Incompletely understood

Related to rapid correction of electrolyte abnormalities

Symptoms include confusion, dysarthria, dysphagia, weakness

Symptoms usually develop 2-3 days after electrolyte correction

Characteristic MR findings develop after 3-6 days after onset of symptoms

Imaging:

Expansion of pons

Hyperintense T2/Hypointense T1

Symmetic involvement with relative sparing of peripheral tissue

Round, triangular, butterfly-shaped central hyperintensity

Extrapontine myelinolysis

Basal ganglia

Cerebral hemispheres

Can occur with/without central pontine myelinolysis