Summary
Two patients with chronic alcohol abuse and central pontine myelinolysis are described. One developed a Korsakoff syndrome 2 days before admission to our hospital and the other showed signs of a incipient delirium without Korsakoff syndrome. Diagnosis of incipient central pontine myelinolysis was based on acute brain-stem dysfunction, serum electrolyte disturbances, malnutrition with vitamin B1 (thiamine), B6 (pyridoxine) and B12 (cyanocobalamine) deficiency in combination with typical neuroradiological findings. Hypokalaemia but no disturbance in serum sodium levels was found in both patients. After correction of hypokalaemia and vitamin deficiency the patients showed complete recovery of neurological and neuropsychological function. The findings are interpreted as suggesting that disturbances in serum potassium levels as well as rapid correction of hyponatraemia may be associated with pontine swelling and dysfunction which, if undetected, leads to central pontine myelinolysis.
References
Adams RD, Victor M, Mancall EL (1959) Central pontine myelinolysis: a hitherto undescribed disease occurring in alcoholic and malnourished patients. Arch Neurol Psychiatry 81:154–172
Berlit P (1986) Die zentrale pontine Myelinolyse. Nervenarzt 57:624–633
Brunner JE, Redmond JM, Haggar AM, Stanton BE (1988) Central pontine myelinolysis after rapid correction of hyponatremia: a magnetic resonance study. Ann Neurol 23:389–391
Colmant HJ, Gocht A (1987) Central pontine and extrapontine myelinolysis: a report of 58 cases. Clin Neuropathol 6:262–270
Deppe A, Haan J (1986) Zentrale pontine Myelinolyse bei Alkoholismus. Nervenarzt 57:609–612
DeWitt LD, Buonanno FS, Kistler JP, Zeffiro T, DeLaPaz RL, Brady TJ, Rosen BR, Pykett LP (1984) Central pontine myelinolysis: demonstration by nuclear magnetic resonance. Neurology 34:570–576
Estol CJ, Faris AA, Martinez AJ, Ahdab-Barmada M (1989) Central pontine myelinolysis after liver transplantation. Neurology 39:493–498
Illowsky BP, Laureno R (1987) Encephalopathy and myelinolysis after rapid correction of hyponatremia. Brain 110:855–867
Messert B, Orrison WW, Hawkins MJ, Quaglieri CE (1979) Central pontine myelinolysis. Neurology 29:147–160
Miller GM, Baker HL, Okazaki H, Whisnant JP (1988) Central pontine myelinolysis and its imitators: MR findings. Radiology 168:795–802
Noremberg MD, Leslie KO, Robertson AS (1981) Association between rise in serum sodium and central pontine myelinolysis. Am Neurol 11:128–135
Pfister HW, Einhäupl KM, Brandt T (1985) Mild central pontine myelinolysis: a frequently undetected syndrome. Eur Arch Psychiatry Neurol Sci 235:134–139
Schroth G (1984) Clinical and CT confirmed recovery from central pontine myelinolytes. Neuroradiology 26:149–151
Takeda K, Sakuta M, Saeki F (1989) Central pontine myelinolysis diagnosed by magnetic resonance imaging. Ann Neurol 36:310–311
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bähr, M., Sommer, N., Petersen, D. et al. Central pontine myelinolysis associated with low potassium levels in alcoholism. J Neurol 237, 275–276 (1990). https://doi.org/10.1007/BF00314635
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00314635