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Sudden parkinsonism, cognitive decline and behavioral changes - drug-induced or other iatrogenic origin?

Publication at First Faculty of Medicine |
2020

Abstract

Central pontine myelinolysis and extrapontine myelinolysis are osmotic demyelination syndromes due to rapid correction of severe hyponatremia. Their clinical manifestations may often vary.

We report a case of a patient with rapid onset of neuropsychiatric symptoms and parkinsonism following rapid correction of hyponatremia, with an initially considered drug-induced etiology. MRI findings compatible with central pontine and extrapontine myelinolysis, however, developed only with a delay of several weeks when clinical symptoms were already disappearing.