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Catatonia due to central pontine and extrapontine myelinolysis: case report
  1. Department of Neurology, Georgetown University Medical Center, Washington DC, USA
  1. Dr Julio Chalela, 4000 Presidential Boulevard, Apartment 213, Philadelphia, PA 19131, USA. Telephone 001 215 878 3311; email:jchalela{at}

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Central pontine and extrapontine myelinolysis (CPEM) are recognised complications of hyponatraemia and its overly rapid correction.1 CPEM usually presents with spastic tetraparesis and pseudobulbar palsy.1 We describe a patient with CPEM in whom behavioural manifestations overshadowed corticospinal tract signs.

A 64 year old Chinese speaking woman with a history of episodic psychotic depression that had never required admission to hospital was admitted to a hospital because of vomiting and diarrhoea. Her general and neurological examination were normal. On admission she had a sodium concentration of 105 meq /l. An infusion of 3% saline at a rate of 150 ml/ hour was given during 6 hours. Ten hours later her sodium was 134 meq/l and she …

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