Immunoglobulins are effective in pontine myelinolysis

Although the exact pathogenesis of central pontine myelinolysis (CPM) is un known, correction of hyponatriemia, thyreotropin releasing hormone, plasmap heresis. and corticosteroids seem to be effective. Assuming intravenous imm unoglobulins (IVIG) to also be effective in CPM. 0.4 g/kg body weight/d imm unoglobulins were applied to a 48-year-old patient who developed CPM with d ouble vision, dysarthria. dysphagia, and left-sided hemiparesis 3 weeks aft er spontaneous normalization of hyponatriemia. After 5 days of IVIG, his sy mptoms markedly improved, confirmed by improvement in the Norris score (42% ), Frenchay score (19%), Kurtzke score (20%), Disability score (54%), vital capacity (26%), and peak, torque (69%). The promising clinical effect of I VIG was assumed to be caused by the reduction of myelinotoxic substances, t he development of antimyelin antibodies, and the promotion of remyelination . In conclusion, IVIG appear to be a promising therapeutic option in CPM.