Isolated extra-pontine myelinolysis in alcohol withdrawal

Abstract

Osmotic demyelination syndromes are often progressive disorders, with clinical features ranging from a mild tremor or dysarthria to a progressive quadriparesis. Although rapid correction of serum sodium is known to be a potent causative factor, additional pathogenic factors exist, which appear critical in predis­posing pontine and extrapontine glia to osmotic stress. Interestingly, several cases of osmotic demyelination have emerged where serum sodium was found to be within normal limits and minimal or no correction of a hypo or hypernatraemic state was implemented. Here we report a case of isolated extra pontine myelinolysis during alcohol withdrawal state, with no sodium fluctuation.