[Central pontine myelinolysis and Schwartz-Bartter syndrome]

Central pontine myelinolysis (CPM) occurred in a typical patient with severe alcoholism presenting with severe initial hyponatremia and a rapidly progressive pontomesencephalic syndrome. A review on 141 cases of CPM is presented and the ties between CPM, hyponatremia/hypoosmolality and the syndrome of inadequate secretion of ADH are discussed. Correct interpretation of the patient's history (alcoholism, severe wasting disease) and the clinical picture (initial hypoosmolality with acute or subacute pontomesencephalic syndrome, possibly locked-in syndrome) should permit correct in-vivo diagnosis more frequently than hitherto.