ABSTRACT
Central pontine myelinolysis (CPM) is a demyelinating disorder of the central basis pons that was first described in malnourished alcoholics by Adams.
Patients with CPM experience a sudden change in mental status, flaccid quadriparesis with hypereflexia, pseudobulbar palsy, and an extensor plantar response unless coma obscures these signs. CPM is associated with the rapid correction or overcorrection of hyponatremia
and the symptoms appear a few days (average 6 days) after overcorrection with intravenous sodium leads to a rise of at least 20 mmol/L. Grossly, victims will be found to have a discolored, finely granular demyelinated zone in the central basis pontis, with
sparing of the tegmentum, ventral pons, and corticospinal tracts (Figure 8.1).
