Serial MRI of extrapontine myelinolysis of the basal ganglia: a case report.

We study a patient with extrapontine myelinolysis (EPM), without central pontine myelinolysis (CPM), who exhibited changes in abnormalities observed with MRI. MRI in the acute stage of the bilateral basal ganglia showed a high signal intensity on T2-weighted images, and a low signal on T1-weighted images. The low signal on T1-weighted images of the lesion in the acute stage changed to a high signal in the subacute stage. This change may reflect the involvement of microhemorrhagic lesions caused by vascular endothelial injury associated with EPM. We propose that vascular endothelial injury due to rapid osmotic change and subsequent demyelination is involved in the patho-etiology of EPM.