[Central pontine myelinolysis]

A review is given on symptoms, etiology, pathogenesis and prognosis of central pontine myelinolysis (CPM). Since 1959, 315 cases of CPM have been reported in world literature, 41 per cent of the patients described developed their neurological symptoms in the course of chronic alcoholism. In about 32 per cent CPM was connected with electrolyte disturbance, especially hypo- or hypernatremia. Beside the complications of alcoholism, accompanying diseases were malignancies (9%) infections of the lung (10%) and diseases of the central nervous system (7%). Current theories about etiology and pathogenesis of CPM are reviewed with special reference to the syndrome of inappropriate secretion of the antidiuretic hormone (IADH). Own experiences with clinical diagnosis of CPM are reported. Seven patients with neurological symptoms in hyponatremia have been seen prospectively during one year. In three cases clinically, in one patient neuropathologically the diagnosis of CPM was made.