Although the exact pathogenesis of central pontine myelinolysis (CPM) is unknown, correction of hyponatremia, thyreotropin releasing hormone, plasmapheresis, and corticosteroids seem to be effective. Assuming intravenous immunoglobulins (IVIG) to also be effective in CPM, 0.4 g/kg body weight/d immunoglobulins were applied to a 48-year-old patient who developed CPM with double vision, dysarthria, dysphagia, and left-sided hemiparesis 3 weeks after spontaneous normalization of hyponatremia. After 5 days of IVIG, his symptoms markedly improved, confirmed by improvement in the Norris score (42%), Frenchay score (19%), Kurtzke score (20%), Disability score (54%), vital capacity (26%), and peak torque (69%). The promising clinical effect of IVIG was assumed to be caused by the reduction of myelinotoxic substances, the development of antimyelin antibodies, and the promotion of remyelination. In conclusion, IVIG appear to be a promising therapeutic option in CPM.
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http://dx.doi.org/10.1097/00002826-200003000-00009 | DOI Listing |
Radiol Bras
January 2025
Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-Unicamp), Campinas, SP, Brazil.
The middle cerebellar peduncle (MCP) is the largest afferent system of the cerebellum and consists of fibres from the cortico-ponto-cerebellar tract. Specifically, several relevant diseases can present with hyperintensity in the MCP on T2-weighted/fluid-attenuated inversion recovery (T2/FLAIR) magnetic resonance imaging sequences, including multiple sclerosis; acute disseminated encephalomyelitis; neuromyelitis optica spectrum disorder; progressive multifocal leucoencephalopathy; hepatic encephalopathy; osmotic demyelination syndrome; multiple system atrophy; fragile X-associated tremor/ataxia syndrome; megalencephalic leucoencephalopathy with subcortical cysts; spinocerebellar ataxias; hemi-pontine infarct with trans-axonal degeneration; and diffuse midline glioma with the histone H3K27M mutation. The aim of this pictorial review is to discuss the imaging findings that are relevant for the differential diagnosis of diseases presenting with MCP hyperintensity on T2/FLAIR sequences.
View Article and Find Full Text PDFNeurol Sci
January 2025
Department of Neurology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China.
J Neurol Sci
February 2025
Department of Clinical Neurological Sciences, Western University, London Health Sciences Centre, London, Ontario, Canada; Department of Pathology and Laboratory Medicine, Western University, London Health Sciences Centre, London, Ontario, Canada. Electronic address:
Objective: To determine the positive predictive value (PPV) of CSF John Cunningham virus (JCV) quantitative PCR (qPCR) for progressive multifocal leukoencephalopathy (PML), and highlight neuroimaging findings reported to be suggestive of this disease.
Methods: We reviewed patients at London Health Sciences Centre with a positive CSF JCV qPCR result. Patients were classified as true-positive if they had a clinico-radiographic presentation compatible with PML and no more likely alternative diagnosis.
East Asian Arch Psychiatry
December 2024
Department of Radiology, Tuen Mun Hospital, Hong Kong SAR, China.
Mymensingh Med J
January 2025
Dr Muhammad Rezeul Huq, Classified Specialist, Department of Neurology, Combined Military Hospital, Dhaka, Bangladesh; E-mail:
Wernicke's encephalopathy is a potentially lethal complication of thiamine deficiency which mainly occurs in chronic alcoholic patients. It may occur in other conditions like hyperemesis gravidarum too. Pregnancy may also be complicated with other neurological and cardiac complications.
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