Central pontine myelinolysis (CPM) is well-recognized osmotic
demyelination syndrome that is related to various conditions such as rapid correction of
hyponatremia and chronic
alcoholism. Acute
ataxia as a sole clinical sign in CPM is rare. We
report a case of a 59-year-old man with
dysarthria,
intention tremor, and a significant
gait ataxia starting after alcohol withdrawal, with radiological evidence of CPM. CPM should be included in the
differential diagnosis of
alcoholic patients who develop a sudden
ataxia. Chronic
alcohol abuse is one of the most commonly encountered
predisposing factors. Alcohol withdrawal represents an additional
vulnerability factor, being responsible for
electrolyte imbalances which are not always demonstrable but are certainly involved in the development of CPM.