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Improvement in Central Pontine Myelinosis with IV immunoglobulin

Authors Ramos VFML, Fernandes Filho JA, Antony AR, Helvey JT, Bertoni J

Received 16 August 2012

Accepted for publication 16 August 2012

Published 2 April 2012 Volume 2012:2 Pages 24—26


Vesper Fe Marie Llaneza Ramos,1 J Americo Fernandes Filho,1 Arun Raj Antony,1 Jason T. Helvey,2 John Bertoni1

Department of Neurological Sciences, University of Nebraska Medical Center; 2Department of Radiology, University of Nebraska Medical Center

Introduction: Central pontine myelinolysis (CPM) is a rare, serious demyelinating disease, associated with rapid correction of chronic hyponatremia, usually in the setting of alcoholism and electrolyte disturbance.1 2 Magnetic resonance imaging (MRI) is a decisive diagnostic tool for CPM.3 The pathogenesis is unknown and there is no established treatment. There have been case reports on the efficacy of intravenous immunoglobulin (IVIG).4 5 Postulated mech-anisms include reduction of myelinotoxic agents, development of antimyelin antibodies, and promotion of remyelination.4 We report a case of CPM associated with chronic alcoholism and hyponatremia, with significant clinical improvement and resolution of MRI changes after treatment with IVIG.  

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