Immunoglobulins are effective in pontine myelinolysis.

Abstract

Although the exact pathogenesis of central pontine myelinolysis (CPM) is unknown, correction of hyponatremia, thyreotropin releasing hormone, plasmapheresis, and corticosteroids seem to be effective. Assuming intravenous immunoglobulins (IVIG) to also be effective in CPM, 0.4 g/kg body weight/d immunoglobulins were applied to a 48-year-old patient who developed CPM with double vision, dysarthria, dysphagia, and left-sided hemiparesis 3 weeks after spontaneous normalization of hyponatremia. After 5 days of IVIG, his symptoms markedly improved, confirmed by improvement in the Norris score (42%), Frenchay score (19%), Kurtzke score (20%), Disability score (54%), vital capacity (26%), and peak torque (69%). The promising clinical effect of IVIG was assumed to be caused by the reduction of myelinotoxic substances, the development of antimyelin antibodies, and the promotion of remyelination. In conclusion, IVIG appear to be a promising therapeutic option in CPM.

• Authors: J Finsterer, E Engelmayer, E Trnka, M Stiskal
• Journal: Clinical neuropharmacology (Clin Neuropharmacol) 2000 Mar-Apr Vol. 23 Issue 2 Pg. 110-3 ISSN: 0362-5664 [Print] United States
• PMID: 10803802 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunoglobulins, Intravenous

Topics

• Adult
• Alcoholism (complications)
• Blood Cell Count
• Blood Chemical Analysis
• Humans
• Immunoglobulins, Intravenous (therapeutic use)
• Immunotherapy
• Injections, Intravenous
• Magnetic Resonance Imaging
• Male
• Myelinolysis, Central Pontine (diagnostic imaging, psychology, therapy)
• Neuropsychological Tests
• Tomography, X-Ray Computed