Myélinolyse centro- et extrapontine chez un patient alcoolique sans troubles hydro-électrolytiques

Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are demyelinating disorders of central nervous system, more commonly associated with rapid correction of hyponatremia. In literature review there are a few cases of CPM/EPM in patients without electrolyte disturbances. We report a case of a 60 year-old man with severe alcoholism, who presented progressive dysarthria complicated, 12 months before his hospitalisation, with anarthria, swallowing disturbance and gait disorders. Examination on admission revealed spastic tetraparesis and pseudo-bulbar palsy. Brain MRI showed demyelinating lesions in the pons and in periventricular white matter compatible with CPM/EPM. Biological assessment was normal. Corticosteroid pulse was performed without efficacy.