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


METHODS
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 alcohol-free follow-up period, the patient's clinical status significantly improved, while the extent of MRI pontine lesion was merely slightly reduced.


CONCLUSIONS
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.
Clinic of Neurology, Clinical Centre of Serbia, Belgrade, Serbia. irdujm@EUnet.rs
Irena
I
Dujmović
Jelena
J
Vitas
Natasa
N
Zlatarić
Jelena
J
Drulović
D000328:Adult; D064829:Alcohol Abstinence; D000437:Alcoholism / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D017590:Myelinolysis, Central Pontine / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D009460:Neurologic Examination / Q000379:methods; D011149:Pons / Q000473:pathology*; D016320:Substance Abuse Treatment Centers / Q000379:methods; D016896:Treatment Outcome