Central pontine myelinolysis

The case is described of a 46 year old female alcoholic, presenting with confusion, jaundice and reduced level of consciousness. The patient was hyponatraemic on admission and despite gradual correction of serum sodium the patient deteriorated neurologically. Magnetic Resonance Imaging scan of the brain revealed characteristic findings of Central Pontine Myelinolysis (CPM). We provide an overview of the first published cases of CPM. The clinical and pathological features of CPM are described. No specific therapy has been shown to improve outcome; current literature advocates supportive management. Identification of patients at risk and gradual correction of hyponatraemia is recommended.