Central pontine myelinolysis complicating hyponatraemia

A case of severe hyponatraemia with long-term neurological sequelae is presented. The patient's electrolyte disturbance was associated initially with symptoms that were consistent with a hyponatraemic encephalopathy, but with correction of the electrolyte imbalance, after a short-term improvement, dramatic deterioration occurred. The neurological symptoms and signs, and associated computed tomographic (CT) scan abnormalities, were consistent with a diagnosis of central pontine myelinolysis. The relationship of central pontine myelinolysis to hyponatraemia and its correction is discussed, and the value of CT scanning in the diagnosis of central pontine myelinolysis is demonstrated.