Early MRI findings of central pontine myelinolysis following "rapid" correction of hyponatraemia during diabetic ketoacidosis. A curious pontine lesion (2003:12b).

We describe a diabetic patient with hyponatraemia and ketoacidosis who developed central pontine myelinolysis (CPM) after a very rapid correction of serum sodium. In diabetic ketoacidosis, the marked shifts in osmolarity make these patients more susceptible to the development of CPM. The dramatic early MRI findings (after three weeks) should raise awareness of the risk of permanent damage to the brain associated with hydration therapy in this susceptible group. Magnetic resonance imaging might be a useful investigation at presentation and follow-up of diabetic patients with extreme metabolic derangements.