Central pontine myelinolysis without hyponatraemia

Area of Science:

• Neurology
• Internal Medicine
• Medical Case Reports

Background:

• Central pontine myelinolysis (CPM) is a rare neurological condition often linked to rapid correction of hyponatremia.
• Alcohol use disorder is a known risk factor for various neurological complications.
• Electrolyte disturbances require careful management to prevent iatrogenic complications.

Observation:

• A 55-year-old woman with a history of excessive alcohol intake presented with electrolyte disturbances.
• During electrolyte correction, the patient developed symptoms suggestive of CPM.
• Unusually, the patient did not present with hyponatremia, a common precursor to CPM.

Findings:

• The patient experienced central pontine myelinolysis despite the absence of hyponatremia.
• The development of CPM occurred during the correction of electrolyte imbalances.
• The patient demonstrated a remarkable and good recovery from the neurological insult.

Implications:

• This case suggests a potential association between rapid osmotic shifts during refeeding and the development of CPM.
• The findings challenge the traditional understanding of CPM's etiology, broadening its potential triggers.
• Further research is warranted to explore the link between refeeding, osmotic shifts, and CPM in diverse patient populations.