Early Diagnosis of Central Pontine Myelinolysis with Diffusion-Weighted Imaging

the setting of rapidly corrected hyponatremia, especially in chronically debilitated patients. Conventional CT and MR imaging findings lag the clinical manifestations of CPM. We present a case in which restricted diffusion was iden-tified within the central pons by using MR diffusion-weighted imaging within 24 hours of onset of patient tet-raplegia and before findings were conspicuous with conventional MR imaging sequences (T1, T2, and fluid-attenuated inversion recovery). Central pontine myelinolysis (CPM) is an osmolar disturbance resulting in demyelination that is initially difficult to detect with convention CT and MR imag-ing. The literature includes several cases in which the temporal evolution of CPM is followed with serial imaging (1–3). There have been a few reports describ