Cognitive dysfunction after central pontine myelinolysis

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9 Scopus citations

Abstract

Central pontine myelinolysis (CPM) is a rare but increasingly recognized neurological disorder associated with a lesion of the central portion of the basis pontis and characterized by altered level of consciousness, seizures, pseudobulbar palsy, dysphagia, and quadriparesis. Until the advent of computerized tomography, CPM was considered fatal and discovered only at post-mortem. The case is reported of a 61-year-old, high-functioning, non-alcoholic man who developed CPM after liver transplantation. Neuropsychological evaluation documented many expected motoric deficits. More unforeseen was this patient's lingering amnestic syndrome and global lowering of many 'higher' cognitive processes, e.g. intelligence, reasoning, concentration, etc. The role of the brainstem in 'higher' cognitive functions is considered through four mechanisms: the reticular activating system, disruption of neocortical-ponto-cerebellar networks, the preliminary processing model, and through interruption of neurotransmitter pathways.

Original languageEnglish (US)
Pages (from-to)173-179
Number of pages7
JournalNeurocase
Volume4
Issue number3
DOIs
StatePublished - Sep 19 1998

Keywords

  • Brainstem dysfunction
  • Central pontine myelinolysis
  • Cognitive disorders
  • Pons

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

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