Central pontine myelinolysis in a chronic alcoholic patient with mild hyponatremia: A case report

INTRODUCTION: Central pontine myelinolysis is a type of osmotic demyelination syndrome, which involves damage to parts of brain most commonly pons. The most common causes include rapid correction of hyponatremia but other precipitating factors including alcoholism, diabetes, and chronic liver disease should also be considered. CASE PRESENTATION: We present a case of 44-year-old male with a history of chronic alcohol consumption, who presented in emergency room with complaints of slurring of speech and weakness of both upper and lower limbs. His MRI brain reveals ‘trident-shaped’ appearance with findings of High T2W/FLAIR signal noted in the pons with relative sparing of the periphery and hypo intense on T1W images. He was managed conservatively. CLINICAL DISCUSSION: Proper diagnosis with MRI is needed for early detection so that proper intervention can be made on time. CONCLUSION: CPM can occur in the patient even if they are normonatremic or hyponatremic but can precipitate in Chronic Alcoholic patients.