Psychiatric symptoms and limb tremors associated with central pontine myelinolysis: A case of alcoholism without hyponatremia

Abstract

Central pontine myelinolysis (CPM), also known as osmotic demyelination syndrome, is a rare demyelinating disorder characterized by the loss of myelin in the center of the basis pontis. In this case report, an alcoholic patient with CPM and acquired demyelinating lesion of the basis pontis is described. The patient is a 70 year‑old woman who presented with intermittent psychiatric symptoms and limb tremors following two months of alcohol abuse. During admission, magnetic resonance imaging (MRI) revealed hyperintensity on T2 weighted images and fluid‑attenuated inversion‑recovery imaging in the central pons without contrast enhancement. The patient's symptoms gradually improved following conservative treatment with vitamins B1 and B12. The one month follow‑up MRI showed a significant reduction of the pontine injury.