Introduction. Central pontine myelinolysis (CPM) is a noninflammatory,
demyelinating lesion usually localised in the basis pontis. Chronic
alcoholism is frequently associated with this condition which may have a
variable clinical outcome. Until now, brain magnetic resonance imaging (MRI)
follow-up in alcoholic CPM cases after alcohol withdrawal has been rarely
described. Case report. We reported a 30- year-old male with a 12-year
history of alcohol abuse, who presented with inability to stand and walk,
nausea, vomiting and somnolence. Neurological examination revealed: impared
fixation on lateral gaze, dysarthria, mild spastic quadriparesis, truncal and
extremity ataxia, sock-like hypesthesia and moderate decrease in vibration
sense in legs. Brain MRI showed a trident-shaped non-enhancing pontine lesion
highly suggestive of CPM. After an eight-month alcoholfree follow-up period,
the patient?s clinical status significantly improved, while the extent of MRI
pontine lesion was merely slightly reduced. Conclusion. The presented case
demonstrates that CPM in chronic alcoholics may have a benign clinical course
after alcohol withdrawal, which is not necessarily associated with the
reduction of lesions on brain MRI.