Central Pontine Myelinolysis: A case report.

Central pontine myelinolysis (CPM) (also known as osmotic demyelination) refers to acute demyelination of the white matter tracts traversing the pons. It seen in the setting of osmotic changes,typically with the rapid correction of hyponatraemia.When the extrapontine structures are affected it is known as extrapontine myelinolysis (EPM). Extrapontine structures which are affected include basal ganglia, midbrain and subcortical white matter. Clinical History, Imaging findings: 62 year old female presented with history of altered sensorium with encephalopathy. MRI performed revealed trident area of altered signal intensity in the central pons. It showed hyperintense signal on T2WI and FLAIR with restriction on DWI. The cortico-spinal tracts were spared. No abnormality was seen in rest of the neuroparenchyma. Blood examination revealed hyponatremia.