Case Reports : A Case of Central Pontine Myelinolysis in a Type 2 Diabetic Patient without Electrolyte Changes

• Published in: Endocrinology and metabolism (Seoul) Vol. 26; no. 3; pp. 263 - 267
• Main Authors: A Ra Jo, Ji Hye Suk, Jong Kun Ha, Chan Woo Jung, Bong Jae Kim, Seong Oh Park, Seon Chool Hwang, Hyun Wook Choi, Mi Kyung Kim
• Format: Journal Article
• Language: Korean
• Published: 대한내분비학회 30.09.2011
• Subjects: Central pontine myelinolysis; Type 2 diabetes mellitus
• ISSN: 2093-596X

Central pontine myelinolysis (CPM) by complicating rapid correction of severe hyponatremia has been widely reported. Additionally, CPM was occasionally reported among patients with post-liver transplantation, burns, chronic renal failure with dialysis, or other diseases associated with or not associated with other electrolyte changes or hyperosmolarity. However, there have been a few reports of CPM occurring in diabetic patients without documented electrolyte changes. This report is, to the best of our knowledge, the first report of CPM in type 2 diabetic patients without electrolyte changes in Korea. A 40-year-old man with type 2 diabetes mellitus with abruptly developed dysarthria and ataxia was admitted to our facility. He suffered from poor glucose control and multiple diabetic complications. Brain magnetic resonance imaging (MRI) revealed a well-defined bilateral symmetric hyperintense lesion in the central portion of the pons on T2- and diffusion-weighted images, which was consistent with CPM. After the patient``s blood glucose and blood pressure normalized, his dysarthria and ataxia improved. Six months after discharge, follow-up MRI showed a persistent, but greatly reduced symmetric lesion in the central pons. It is certainly possible for CPM to be overlooked clinically in diabetic patients, but more cases could be diagnosed if careful attention was paid to this syndrome. (Endocrinol Metab 26:263-267, 2011)