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Hyponatremic osmotic demyelination (4)

T2-weighted MRI in a 41-year-old woman who presented with acute parkinsonism following slow correction of hyponatremia resulting from repeated vomiting, and whose initial MRI was consistent with extrapontine myelinolysis. MRI after two months showing marked improvement, mainly in the putamena (long black arrow). (Source: Sajith J, Ditchfield A, Katifi HA. Extrapontine myelinolysis presenting as acute parkinsonism. BMC Neurol 2006;6:33. Creative Commons Attribution license [CC BY],

Associated Disorders

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