Central pontine myelinolysis with widespread extrapontine lesions: a report of two cases.

Two cases of central pontine myelinolysis with extensive extrapontine lesions are described. Both occurred in patients with longstanding quadriplegia in whom severe hyponatraemia, occurring in a setting of respiratory infection, was rapidly corrected with hypertonic saline. The extrapontine lesions resembled those described in extrapontine myelinolysis, but the possibility that an anoxic-ischaemic component may have contributed is discussed. The clinical data in these two cases are consistent with the mounting body of clinical and experimental evidence that disturbances of sodium balance may be an important cause of central pontine and extrapontine myelinolysis.