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Images in Neurology
June 2005

Ring-Enhancing Lesion in Central Pontine Myelinolysis

Arch Neurol. 2005;62(6):1016-1017. doi:10.1001/archneur.62.6.1016

A 4-year-old boy was seen in an emergency department after 3 days of vomiting and watery diarrhea. After his sodium level decreased from 136 to 118 mEq/L, he had a seizure, resulting in respiratory arrest, and required mechanical ventilation. His sodium level increased to 128 mEq/L with rehydration, but he developed “locked-in syndrome.”

His initial magnetic resonance image revealed increased signal lesions in the left pons, right basal ganglia region, and both medial temporal lobes (Figure).