Slowly progressive dystonia following central pontine and extrapontine myelinolysis

Intern Med. 2000 Nov;39(11):956-60. doi: 10.2169/internalmedicine.39.956.

Abstract

A 28-year-old woman was hospitalized with dysarthria and oro-mandibular and upper limb dystonia. Approximately 8 years prior to the current admission, the woman became severely hyponatremic due to traumatic subarachnoid hemorrhage-related SIADH. Brain MRIs showed a signal increase in the central pons, thalamus and striatum on T2 weighted images compatible with central pontine and extrapontine myelinolysis. From a few months after that event, dystonia progressed slowly over the subsequent 8 years. We speculate that the particular damage chiefly to the myelin structures by myelinolytic process may have caused an extremely slow plastic reorganization of the neural structures, giving rise to progressive dystonia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Disease Progression
  • Dystonia / etiology*
  • Female
  • Humans
  • Myelinolysis, Central Pontine / complications*
  • Time Factors