DIAGNOSIS OF EXTRAPONTINE MYELINOLYSIS PR ECEDING PONTINE MYELINOLYSIS

An MR study performed on a patient who presented a tetraplegia after l iver transplantation, revealed bilateral hypersignal of internal globu s pallidus on T2 weighted images. Diagnosis of extrapontine myelinolys is was proposed based on clinical presentation and lesions topography, although absence of natremic disorders. Confirmation of diagnosis was obtained on an MR study performed a month later, which demonstrated a pontine extension. Extrapontine myelinolysis can precede pontine invo lvement. Diagnosis of myelinolysis should be evoked although MR normal appearence of the pons.