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October 1977

Brain Stem Auditory-Evoked Responses-Reply

Author Affiliations

Dept of Neurology Mayo Clinic Rochester, MN 55901
Dept of Neurosciences Univ of California San Diego, CA 92093

Arch Neurol. 1977;34(10):650. doi:10.1001/archneur.1977.00500220084021

In Reply.—  We apologize to Dr Khurana for overlooking his previous report of recovery from suspected central pontine myelinolysis (CPM). As he points out, the localization of the lesion in his and our cases was indeed "clinically obvious," as one would hope with such a presumptive diagnosis. However, the localization of the lesion has not been clinically obvious in most of the 100 or more cases of proved CPM reported in the literature; we know of only three of these cases in which the lesion was recognized clinically.1-3 Several reports have emphasized that the localization of the lesion is not often discernible from the clinical findings, even in retrospect.4-6 There are several reasons for this: (1) the lesion may remain confined to the functionally silent area in the midline of the basis pontis where it originates, producing no signs or symptoms7; (2) with centrifugal spread of the lesion