Cerebellar peduncular myelinolysis in a patient receiving hemodialysis

Kim, J.; Song, Thomas; Park, S.; Choi, In‐Su

doi:10.1016/j.jns.2006.10.012

Cited by 22 publications

(10 citation statements)

References 12 publications

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“…The brain MRI of our patient showed high signal intensity in the extrapontine regions, including middle cerebellar peduncle, but sparing the basis pontis shown by diffusion-weighted imaging. Only two cases of cerebellar peduncular myelinolysis without involvement of the central pontine area have been reported; these patients showed an altered state of consciousness and gait disturbance, which were attributable to conditions such as alcoholism or end-stage kidney disease [ 9 , 10 ]. Unlike other cases, in this case, the underlying disease was progressive malignancy.…”

Section: Discussionmentioning

confidence: 99%

Reversible Cerebellar Ataxia Related to Extrapontine Myelinolysis without Hyponatremia after Cisplatin-Based Chemotherapy for Cholangiocarcinoma

et al. 2014

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A 60-year-old woman presented with cerebellar signs including dysarthria and ataxia, after intravenous infusion of cisplatin-based chemotherapy. Several blood tests showed mild neutropenia, normocytic normochromic anemia, but no evidence of a marked hyponatremia. Brain magnetic resonance imaging with diffusion-weighted sequences showed hyper-intense signal abnormalities in the extrapontine region, sparing the basis pontis. Here, we report on the case of a patient with reversible cerebellar ataxia related to extrapontine myelinolysis without hyponatremia after treatment with cisplatin-based chemotherapy for cholangiocarcinoma and discuss the literature on cerebellar ataxia in patients who underwent recent chemotherapy for malignancy.

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Section: Discussionmentioning

confidence: 99%

Reversible Cerebellar Ataxia Related to Extrapontine Myelinolysis without Hyponatremia after Cisplatin-Based Chemotherapy for Cholangiocarcinoma

et al. 2014

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“…Follow‐up MRI on POD 20 showed progressive disease consistent with EPM. Although the involvement of EPM in the cerebellar peduncles is uncommon, such lesions have been reported (21, 22). Despite the radiographic progression of myelinolysis, the ADC calculations showed gradual resolution of demyelination in the pons, corresponding to the patient’s slow clinical recovery marked by increased responsiveness and spontaneous eye opening.…”

Section: Discussionmentioning

confidence: 99%

Central pontine myelinolysis: A case report and clinical–pathological review

Cui

Fayek

Rand

et al. 2011

Pediatric Transplantation

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An 11-yr-old child presented with acute mental status changes and spastic quadriplegia after orthotopic liver transplantation. Magnetic resonance (MR) imaging findings were consistent with central pontine and EPM. Initial immunosuppression included tacrolimus, mycophenolate mofetil, and corticosteroids. Given that neurotoxicity is a well-established side effect of CNI, the patient was converted to rapamycin and subsequently experienced significant neurologic recovery. The temporal resolution of the patient's symptoms suggests that prompt recognition of central pontine and EPM and conversion from tacrolimus to rapamycin during the early post-operative course may have therapeutic benefits for patients undergoing pediatric transplant with CNI-related neurotoxicity.

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“…Rapid plasma osmotic fluctuations during haemodialysis can result in central pontine myelinolysis (osmotic demyelination syndrome) 11. This is more likely in patients with chronic hyponatraemia and elevated serum osmolality.…”

Section: Neurological Complications Associated With Dialysismentioning

confidence: 99%

Neurological complications of renal dialysis and transplantation

Karunaratne

Taube²,

Khalil

et al. 2017

Pract Neurol

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Neurological complications from renal replacement therapy contribute significantly to morbidity and mortality in patients with renal failure. Such complications can affect either the central or peripheral nervous systems. Most neurological disturbances associated with the uraemic state do not respond fully to renal replacement therapy. There are also complications specifically associated with dialysis and transplantation. A multidisciplinary approach, involving both nephrologists and neurologists, is critical for the diagnosis and effective management of these disorders.

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Cerebellar peduncular myelinolysis in a patient receiving hemodialysis

Cited by 22 publications

References 12 publications

Reversible Cerebellar Ataxia Related to Extrapontine Myelinolysis without Hyponatremia after Cisplatin-Based Chemotherapy for Cholangiocarcinoma

Reversible Cerebellar Ataxia Related to Extrapontine Myelinolysis without Hyponatremia after Cisplatin-Based Chemotherapy for Cholangiocarcinoma

Central pontine myelinolysis: A case report and clinical–pathological review

Neurological complications of renal dialysis and transplantation

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