Combined central and peripheral demyelination

Acquired central and peripheral demyelination in the same patient is a very rare feature. We report a 52-year-male patient with the chronic autoimmune hepatitis (CAH) presenting with pure motor areflexic quadriparesis from 4 months and recent onset of drowsiness of 4 days duration. Studies of imaging and electrophysiology suggested central pontine myelinolysis and chronic inflammatory demyelinating polyradiculoneuropathy. Patient was effectively treated with high dose steroids. To the best of our knowledge, this is the first case of central and peripheral demyelination in a patient with CAH.