Reversible Cerebellar Ataxia Related to Extrapontine Myelinolysis without Hyponatremia after Cisplatin-Based Chemotherapy for Cholangiocarcinoma

다국어 초록 (Multilingual Abstract)

A 60-year-old woman presented with cerebellar signs including dysarthria and ataxia,after intravenous infusion of cisplatin-based chemotherapy. Several blood testsshowed mild neutropenia, normocytic normochromic anemia, but no evidence of amarked hyponatremia. Brain magnetic resonance imaging with diffusion-weightedsequences showed hyper-intense signal abnormalities in the extrapontine region,sparing the basis pontis. Here, we report on the case of a patient with reversiblecerebellar ataxia related to extrapontine myelinolysis without hyponatremia aftertreatment with cisplatin-based chemotherapy for cholangiocarcinoma and discussthe literature on cerebellar ataxia in patients who underwent recent chemotherapyfor malignancy.

참고문헌 (Reference)

1 Forster A, "Value of diffusion-weighted imaging in central pontine and extrapontine myelinolysis" 55 : 49-56, 2013

2 Ho VB, "Resolving MR features in osmotic myelinolysis(central pontine and extrapontine myelinolysis)" 14 : 163-167, 1993

3 Patel SV, "Resolution of MRI findings in central pontine myelinosis associated with hypokalemia" 334 : 490-492, 2007

4 Weissman JD, "Pontine myelinolysis and delayed encephalopathy following the rapid correction of acute hyponatremia" 46 : 926-927, 1989

5 King JD, "Osmotic demyelination syndrome" 339 : 561-567, 2010

6 Kim J, "Cerebellar peduncular myelinolysis in a patient receiving hemodialysis" 253 : 66-68, 2007

7 Steller U, "Cerebellar ataxia with recovery related to central pontine myelinolysis" 235 : 379-381, 1988

8 Dolciotti C, "Cerebellar ataxia with complete clinical recovery and resolution of MRI lesions related to central pontine myelinolysis : case report and literature review" 2 : 157-162, 2010

9 Bahr M, "Central pontine myelinolysis associated with low potassium levels in alcoholism" 237 : 275-276, 1990

10 Yau TK, "Central pontine myelinolysis : report of two occurrences after cisplatin-containing chemotherapy for nasopharyngeal carcinoma" 5 : 395-396, 1993

11 Adams RD, "Central pontine myelinolysis : a hitherto undescribed disease occurring in alcoholic and malnourished patients" 81 : 154-172, 1959

12 Martin RJ, "Central pontine and extrapontine myelinolysis: the osmotic demyelination syndromes" 75 (75): 22-28, 2004

13 Garzon T, "Ataxic form of central pontine myelinolysis" 1 : 517-518, 2002