Cerebellar Ataxia with Complete Clinical Recovery and Resolution of MRI Lesions Related to Central Pontine Myelinolysis: Case Report and Literature Review

• Main Authors: Cristina Dolciotti, Angelo Nuti, Gabriele Cipriani, Paolo Borelli, Filippo Baldacci, Chiara Logi, Ubaldo Bonuccelli
• Format: Article
• Language: English
• Published: Karger Publishers 2010-12-01
• Series: Case Reports in Neurology
• Subjects: Central pontine myelinolysis; Cerebellar ataxia; Chemotherapy; Complete recovery; Hyponatremia
• Online Access: http://www.karger.com/Article/FullText/323429

There are several reports of central pontine myelinolysis (CPM) in a setting of malnutrition, alcoholism, and chronic debilitating illness associated with electrolyte abnormalities, especially hyponatremia. The cause of myelinolysis is still under debate, and, although osmotic effects are thought to be responsible in most cases, alternative pathological factors should be considered [King et al.: Am J Med Sci 2010;339:561–567]. We report a case of CPM in a patient with recent chemotherapy for colon cancer without electrolyte unbalance and otherwise unexplained causes. Moreover, the present case is an example of the unusual clinical ataxic variant, followed by complete recovery without any specific treatment. The diagnosis was confirmed by MRI, which showed a characteristic hyperintense signal abnormality in the central part of the pons with an unaffected outer rim. One month later, we observed complete resolution of clinical and radiological symptoms.