CENTRAL PONTINE MYELINOLYSIS - A REPORT O F 2 CASES IN CHILDREN

Background. - Central pontine myelinolysis has been rarely reported in children. This report concerns two children, aged 4 1/2 years. Case r eports. - The main clinical features were altered level of consciousne ss, tetraplegia and signs of brain stem dysfunctions. In both cases, m agnetic resonance imaging (MRI) revealed hypersignal of protuberance i n association with cerebellar lesion in one case and occipital lesion in the other, compatible with central and extrapontine myelinolysis. N o underlying disease or electrolytic disorders was identified. Clinica l outcome was good. Mental status was normal after 9 months for patien t one and 4 months for patient two. The MRI abnormality was reduced at 9-month follow-up in patient two and unchanged at 4 months in patient one. Conclusion. - The incidence of central pontine myelinolysis is p robably underestimated in children. MRI allows a greater sensitivity i n identifying areas of focal demyelination where diagnosis was previou sly only established by post mortem studies.