Náhle vzniklý parkinsonský syndrom, kognitivní porucha a změny chování – polékový nebo jiný iatrogenní původ? // SOLEN

Neurológia pre prax 1/2019

Sudden parkinsonism, cognitive decline and behavioral changes – drug-induced or other iatrogenic origin?

Central pontine myelinolysis and extrapontine myelinolysis are osmotic demyelination syndromes due to rapid correction of severe hyponatremia. Their clinical manifestations may often vary. We report a case of a patient with rapid onset of neuropsychiatric symptoms and parkinsonism following rapid correction of hyponatremia, with an initially considered drug-induced etiology. MRI findings compatible with central pontine and extrapontine myelinolysis, however, developed only with a delay of several weeks when clinical symptoms were already disappearing.

Keywords: central pontine myelinolysis, extrapontine myelinolysis, osmotic demyelination syndrome, parkinsonism