IMAGES IN EMERGENCY MEDICINE
When neurological deficit is not a stroke
Russells Hall Hospital, Dudley, UK
Correspondence to:
Dr Ranjna Garg, Russells Hall Hospital, Dudley, UK; ranjnagarg@yahoo.com
Accepted 27 October 2006
| The first 150 words of the full text of this article appear below. |
A 65-year-old man with a history of alcohol abuse was admitted with double vision, numbness and light-headedness. A physical examination showed no significant abnormality but a neurological examination showed right abducens palsy, left facial nerve palsy and internuclear ophthalmoplegia (failure to adduct on left side with nystagmus in the opposite, abducting eye). Blood results showed normal full blood count, renal and liver biochemistry, serum electrolytes, vasculitic screen, complement levels and autoimmune serology. A magnetic resonance scan of the brain (fig 1) showed ill-defined focal hyperintensity in the central part of the pons (circled) consistent with central pontine myelinosis (CPM). The patient was treated with an alcohol detoxification regimen and was advised to stop drinking alcohol. The neurological deficit improved slowly over months.
Figure 1 Magnetic resonance scan of the brain showing ill-defined focal hyperintensity in the central part of the pons (circled) consistent with central pontine myelinosis.
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