Central pontine myelinosis following alcohol withdrawal: report of two cases

Abstract

Osmotic demyelination syndrome (ODS) is a non-inflammatory demyelination illness and it includes both central pontine myelinolysis (CPM) and extrapontine myelinosis (EPM). These neurological conditions can rarely develop after alcohol withdrawal. While the precise pathophysiology of EPM and CPM is still unknown, various studies indicate that vasogenic edema is a major element in EPM while cytotoxic edema is a key factor in CPM. Here we present two patients who were diagnosed with central pontine myelinolysis following alcohol withdrawal and showed improvement with steroid therapy. Further studies are needed to demonstrate the effectiveness of steroid treatment in these patients. This case is highlighted due to the rarity of the disease and the observed benefits of high-dose steroid therapy.