Parkinsonism and dystonia in central pontine and extrapontine myelinolysis

Parkinsonism as well as dystonic signs are rarely seen incentral pontine myelinolysis and extrapontine myelinolysis. A 51yearold woman developed central pontine myelinolysis and extrapontine myelinolysis with parkinsonism after severe vomiting which followed alcohol and drug intake, even though marked hyponatraemia had beencorrected gradually over six days. Parkinsonism resolved four monthsafter onset, but she then exhibited persistent retrocollis, spasmodicdysphonia, and focal dystonia of her left hand. Although the medicalliterature documents three similar patients, this patient is differentas dystonic symptoms only developed four months after parkinsoniansigns had resolved.