Extensive extrapontine and central pontine myelinolysis associated with correction of profound hyponatraemia

The relationship between correction of hyponatraemia and the development of central pontine myelinolysis (CPM) remains controversial. A case of CPM associated with extensive extrapontine demyelination is described. Profound hyponatraemia and its subsequent correction are documented. It is suggested that the extent of demyelination reflects the degree of hyponatraemia noted prior to correction, supporting current hypotheses regarding the role of hyponatraemia in CPM. This case is unusual in that other recognized risk factors for the development of CPM are absent.