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Central Pontine and Extrapontine Myelinolysis Owing to Disequilibrium Syndrome

Department of Pediatric Neurology, ofaydin{at}yahoo.com.

Çi dem Üner, MD

Division of Radiology

Nesrin enbil, MD

Department of Pediatric Neurology

Kenan Bek, MD

Department of Pediatric Neurology

Özlem Erdoan, MD

Department of Pediatric Neurology

Y.K. Yavuz Gürer, MD

Department of Pediatric Neurology Dr. Sami Ulus Children's Hospital Ankara, Turkey

Neurologic disorders can be seen in patients with end-stage renal failure owing to complications of hemodialysis or peritoneal dialysis. The disequilibrium syndrome can be seen, usually soon after or toward the end of dialysis. We report a patient with central pontine and extrapontine myelinolysis owing to disequilibrium syndrome. The patient had depressed consciousness, agitation, tremor, stupor, and hyperactive deep tendon reflexes toward the end of the second peritoneal dialysis. A brain computed tomographic (CT) scan showed hypodense lesions in pontine and extrapontine locations without radiocontrast medium enhancement. After 2 days, the patient had only minimal memory deficits. A control brain CT scan 1 week later showed a decrease of the lesions in central pontine and extrapontine locations. Central pontine and extrapontine myelinolysis should be suspected and investigated in the acute neurologic disorders of dialysis patients. (J Child Neurol 2003;18:292—296).

Journal of Child Neurology, Vol. 18, No. 4, 292-296 (2003)
DOI: 10.1177/08830738030180040701


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