{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:25:03Z","timestamp":1791854703354,"version":"4.3.4"},"reference-count":46,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T00:00:00Z","timestamp":1705968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Central pontine myelinolysis (CPM) is a rare demyelinating disease that affects the pons and which can cause extreme disabilities such as locked\u2010in syndrome (LIS) in the initial phase. The aim of the study was to describe the evolution over a 12\u2010month period of two patients with CPM causing an initial LIS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We retrospectively report the unexpected clinical outcome of these two patients in relation with the anatomical damages documented by brain MRI, associated with diffusion tensor imaging and reconstruction of corticospinal tracts in tractography. The following clinical parameters systematically assessed at 3, 6, 9, and 12\u2009months: muscle testing on 12 key muscles (Medical Research Council), prehension metrics (box and block test and purdue pegboard), and independence for acts of daily living (functional independence measure).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Both patients showed a progressive recovery beginning between 2 and 3\u2009months after the onset of symptoms, leading to almost complete autonomy at 12\u2009months (FIM\u2009&gt;\u2009110), with motor strength greater than 4\/5 in all joint segments (MRC\u2009&gt;\u200950\/60). On brain MRI with tractography, CST appeared partially preserved at pons level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>The possibility of a near\u2010complete functional recovery at 12\u2009months is important to consider given the ethical issues at stake and the discussions about limiting care that may take place initially. It seems to be the consequence of reversible myelin damage combined with partially preserved neurons. Development of collateral pathways or resolution of conduction block may explain this recovery. MRI comprising DTI and tractography could play a key role in the prognosis of motor recovery.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51994","type":"journal-article","created":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T07:32:03Z","timestamp":1706081523000},"page":"826-836","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Locked\u2010in syndrome after central pontine myelinolysis, an outstanding outcome of two patients"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5046-0876","authenticated-orcid":false,"given":"Ma\u00eflys","family":"Chabert","sequence":"first","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Hospices Civils de Lyon  Lyon France"},{"name":"University Lyon 1 Claude Bernard  Villeurbanne 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