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Hyponatremic osmotic demyelination (2)

T2-weighted FLAIR in a 41-year-old woman who presented with acute parkinsonism following slow correction of hyponatremia resulting from repeated vomiting. Images showed bilaterally symmetrical hyperintensities in the caudate nuclei (small, thin, black arrow) and putamena (long black arrow), with sparing of globi pallidi (broad black arrow), consistent with extrapontine myelinolysis. (Source: Sajith J, Ditchfield A, Katifi HA. Extrapontine myelinolysis presenting as acute parkinsonism. BMC Neurol 2006;6:33. Creative Commons Attribution license [CC BY], https://creativecommons.org/licenses/by/2.0.)

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Associated Disorders

  • Alcoholism
  • Extrapontine myelinolysis
  • Hyperosmolar hyperglycemic state
  • Hypokalemia
  • Malnutrition
  • Osmotic myelinolysis