Myélinolyse centropontine avec natrémie normale chez un sujet diabétique de type 2 : rôle de l'hyperglycémie ?

A 56 year-old patient was hospitalized for hemiparesis associated with aphasia in a major hyperglycemic disequilibrium without other electrolyte disorders. The diagnosis of central pontine myelinolysis was retained after analysis of the magnetic resonance imaging finding typical pontine lesions. His symptoms regressed within a few days after correction of hyperglycemia. This rare diagnosis with uncertain pathophysiology has not to be ignored and must be differentiated from stroke. It is associated with a huge hyperosmolarity and must be corrected in a prudent manner.