Extrapontine myelinolysis with parkinsonism after rapid correction of hyponatremia: high cerebrospinal fluid level of homovanillic acid and successful dopaminergic treatment

J Neural Transm (Vienna). 1999;106(9-10):949-53. doi: 10.1007/s007020050215.

Abstract

Extrapontine myelinolysis (EPM) is a demyelinating process of the brain. We report the case of an 11-year-old girl who developed EPM with parkinsonism. Magnetic resonance imaging revealed demyelinating patterns in the basal ganglia without central pontine lesions. The cerebrospinal fluid levels of homovanillic acid and 5-hydroxyindoleacetic acid were high at the time of onset and normalized upon complete recovery from extrapyramidal symptoms after a dopaminergic treatment. We speculated that demyelination of nerve fibers containing dopamine receptors in the striatum might be a main cause of these symptoms.

Publication types

  • Case Reports

MeSH terms

  • Antiparkinson Agents / therapeutic use
  • Basal Ganglia / pathology
  • Child
  • Female
  • Homovanillic Acid / cerebrospinal fluid*
  • Humans
  • Hydroxyindoleacetic Acid / cerebrospinal fluid*
  • Hyponatremia / drug therapy
  • Isotonic Solutions / therapeutic use
  • Magnetic Resonance Imaging
  • Myelinolysis, Central Pontine / cerebrospinal fluid*
  • Myelinolysis, Central Pontine / diagnosis
  • Myelinolysis, Central Pontine / physiopathology
  • Parkinsonian Disorders / cerebrospinal fluid*
  • Parkinsonian Disorders / diagnosis
  • Parkinsonian Disorders / drug therapy
  • Sodium Chloride / therapeutic use

Substances

  • Antiparkinson Agents
  • Isotonic Solutions
  • Sodium Chloride
  • Hydroxyindoleacetic Acid
  • Homovanillic Acid