CT and MR findings in central pontine and extrapontine myelinolysis : A study of two patients

Central pontine and extrapontine myelinolysis is a distinctive clinical syndrome and has characteristic CT and MR features. We describe two patients who presented with nasopharyngeal carcinoma, severe hyponatremia, and had quick correction of hyponatremia. Low T1 and high T2 signal alterations were seen in the basal ganglia and caudate nuclei in both patients whilst one of them had concommitant ventrolateral thalami and central pontine region involvement. Neurologic recovery was good in one case, and initially seen in the other patient before death resulted from septicaemia. Peripheral enhancement of the basal ganglia and caudate nuclei was seen in one patient, which we believe is a new feature.