Secondary Parkinsonism due to Extrapontine Myelinolysis without Central Pontine Myelinolysis: A case report.

, Park, Jae Heung; , Chang, Jae Hyeok; , Park, Ji Sang; , Cho, Si Chul

Case Report

Journal of the Korean Academy of Rehabilitation Medicine 2007;31(1):119-112.

Park, Jae Heung , Chang, Jae Hyeok , Park, Ji Sang , Cho, Si Chul

¹Department of Rehabilitation Medicine, Pusan National University College of Medicine, Korea. kulu73@medimail.co.kr
²Department of Rehabilitation Medicine,Pusan Medical Center, Korea.

중심뇌교 침범 없이 나타난 뇌교외 수초용해로 인한 이차성 파킨슨증 1례 ⁣증례 보고⁣

박재흥, 장재혁, 박지상, 조시철¹

부산대학교 의과대학 재활의학교실, ¹부산의료원 재활의학과

Abstract

Parkinsonism is characterized by clinical symptoms of rigidity, bradykinesia, tremor, and gait disturbance. There are many causes of secondary parkinsonism. The present report discusses a secondary parkinsonism of extrapontine myelinolysis (EPM) without central pontine myelinolysis (CPM) after rapid correction of hyponatremia. EPM is a demyelinating process of the brain. EPM with CPM is relatively common, but EMP without CPM is rare. A 57- year-old woman with Tsutsugamushi disease had a subacute onset of parkinsonism on the fourteenth day after a rapid correction of severe hyponatremia. Magnetic resonance imaging of the bilateral basal ganglia showed a high signal intensity on T2-weighted images, and a low signal on T1- weighted images. She was started on levodopa, and parkinsonian features slowly improved. We report an unusual case of EPM without CPM, that presented with parkinsonism. (J Korean Acad Rehab Med 2007; 31: 119-122)

Key Words: Extrapontine myelinolysis, Parkinsonism, Hyponatremia