Thalamic extrapontine lesions in central pontine myelinolysis.

Central pontine myelinolysis (CPM) is a well-known entity first described by Adams et al. in 1959 [1). This demyelinating disorder is associated with electrolyte disturbances (particularly of sodium) and typically occurs in the setting of alcoholism and malnutrition . Extrapontine myelinolysis (EPM) is identified pathologically in about 53% of cases [2] and, of these, thalamic lesions are detected in 34%. Recent case reports have described MR findings in EPM of the putamina, caudate nuclei , and midbrain [3-5). Thalamic lesions were also ident ified in two case reports of CPM [6, 7]. We present three cases in which symmetric thalamic lesions are demonstrated by MR in CPMfEPM and address the characteristic pattern and location of involvement within the thalami.