Central pontine myelinolysis in a chronic alcoholic: A clinical and brain magnetic resonance imaging follow-up

• Main Authors: Dujmović Irena, Vitas Jelena, Zlatarić Nataša, Drulović Jelena
• Format: Article
• Language: English
• Published: Military Health Department, Ministry of Defance, Serbia 2013-01-01
• Series: Vojnosanitetski Pregled
• Subjects: demyelinating diseases; pons; diagnosis; magnetic resonance imaging; alcoholism; treatment outcome
• Online Access: http://www.doiserbia.nb.rs/img/doi/0042-8450/2013/0042-84501308785D.pdf

Introduction. Central pontine myelinolysis (CPM) is a noninflammatory, demyelinating lesion usually localised in the basis pontis. Chronic alcoholism is frequently associated with this condition which may have a variable clinical outcome. Until now, brain magnetic resonance imaging (MRI) follow-up in alcoholic CPM cases after alcohol withdrawal has been rarely described. Case report. We reported a 30- year-old male with a 12-year history of alcohol abuse, who presented with inability to stand and walk, nausea, vomiting and somnolence. Neurological examination revealed: impared fixation on lateral gaze, dysarthria, mild spastic quadriparesis, truncal and extremity ataxia, sock-like hypesthesia and moderate decrease in vibration sense in legs. Brain MRI showed a trident-shaped non-enhancing pontine lesion highly suggestive of CPM. After an eight-month alcoholfree follow-up period, the patient’s clinical status significantly improved, while the extent of MRI pontine lesion was merely slightly reduced. Conclusion. The presented case demonstrates that CPM in chronic alcoholics may have a benign clinical course after alcohol withdrawal, which is not necessarily associated with the reduction of lesions on brain MRI. [Projekat Ministarstva nauke Republike Srbije, br. 175031]