Evolution of pontine and extrapontine myelinolysis

We report on the serial computed tomographic (CT) changes in the brainstem and cerebral hemispheres of a woman with autopsy-proven pontine and extrapontine myelinolysis who survived for 14 months. The earliest finding was diffuse decreased attenuation values of the gray matter resulting in poor gray-white matter differentiation. Anterior temporal lobe involvement, a finding not previously reported, was demonstrated on CT and confirmed by neuropathologic examination.