Central Pontine and Extrapontine Myelinolysis without Hyponatremia after Alcohol Withdrawal: One Case Report

ABSTRACT

Central pontine myelinolysis (CPM) is a demyelinating disorder that was first described by Adams et al. in 1959 in patients with a history of alcoholism and malnutrition. It is characterized by delirium, quadriparesis, pseudobulbar palsy, and dysarthria. A subgroup of patients at risk for CPM are chronic alcoholics, malnutrition, diabetes, liver transplantation, hepatic disease, advanced age. Although the cause and pathogenesis remains unclear, but many studies have implicated that the rapid correction of hyponatremia is the major factor associated with CPM. But CPM without hyponatremia has been rarely reported. Diagnosis is confirmed by MR image. Here we present one case of CPM without electrolyte disturbance after alcohol withdrawal in a chronic alcoholic with literature reviews.