BILATERAL INTERNUCLEAR OPHTHALMOPLEGIA AS FIRST MANIFESTATION OF EXTRA PONTINE MYELINOLYSIS
Journal Title: International Journal of Medical Research & Health Sciences (IJMRHS) - Year 2014, Vol 3, Issue 3
Abstract
Extrapontine myelinolysis (EPM) is a rare clinical entity affecting anterior basal ganglia. This is one of the osmotic demyelination syndromes. It occurs due to rapid correction of hyponatremia and also rarely occurs in alcoholics. It generally presents with extrapyramidal symptoms. We here report a case of EPM in a 13 year old boy presenting with bilateral internuclear ophthalmoplegia and ptosis. The patient also had generalised weakness, but no psychiatric symptoms. The patient slowly recovered over six months. EPM can affect any age group, although the elderly are more likely to be affected due to frequent electrolyte abnormalities. Ocular movement disorders or brainstem signs are rarely reported in EPM. When present, it can create diagnostic confusion with multiple sclerosis. We believe this is the first report of this entity from India. The relevant literature regarding brainstem manifestations in myelinolysis syndromes is also discussed, along with the radiological findings.
Authors and Affiliations
Tushar Kanti Bandyopadhyay| Assistant Professor, Department of Medicine, Medical College Kolkata88, College Street, Kolkata, West Bengal, Rudrajit Paul| Assistant Professor, Department of Medicine, Medical College Kolkata88, College Street, Kolkata, West Bengal, Amit K Das| Resident, Department of Medicine, Medical College Kolkata88, College Street, Kolkata, West Bengal, Corresponding author email: docr89@gmail.com, Rathindranath Sarkar| Professor, Department of Medicine, Medical College Kolkata88, College Street, Kolkata, West Bengal
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- EP ID EP11245
- DOI 10.5958/2319-5886.2014.00428.7
- Views 329
- Downloads 11
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