Central pontine myelinolysis

Abstract

Sixteen new cases of central pontine myelinolysis are described. Myelin is destroyed with relative preservation of the axis cylinders. Occasionally central cavitation is present and it seems evident that the lesion does not arise from multiple foci. The disease is characterized by its singularity, lack of ischemic changes in the nerve cells, and the absence of any occlusive lesions in the basilar artery or its branches. In view of this, anoxia hardly seems a causative factor. The association of this disease with alcoholism is most impressive. It is likely that central pontine myelinolysis is caused by a toxic substance, exposure to which is more prevalent in alcoholics. At present there is no explanation for the absence of this lesion in Negro male alcoholics.