Central pontine and extra-pontine myelinolysis are a well known complication of 
hyponatremia. Other causes may be present. We report a case of head injury in a 
13 year-old girl, who recovered well after surgery for extra-dural hematoma, but 
presented endocrinological disorders with hyperglycemia followed by a severe 
hyponatremia. Despite the correction of these metabolic disorders, the patient 
became comatose, and MRI, on T2 weighted image, showed hyperintense signals in 
the basal ganglia consistent with extra-pontine myelinolysis. The patient's 
state remained unchanged for six weeks. Since S. Konno and H. Wakui published 
cases of myelinolysis who dramatically improved after TRH treatment, the patient 
was given 0.6 mg i.v daily of TRH for six weeks. Improvement began within a few 
days, and continued until complete recovery.