Improvement in Central Pontine Myelinosis with IV immunoglobulin

Introduction: Central pontine myelinolysis (CPM) is a rare, serious demyelinating disease, associated with rapid correction of chronic hyponatremia, usually in the setting of alcoholism and electrolyte disturbance.1 2 Magnetic resonance imaging (MRI) is a decisive diagnostic tool for CPM.3 The pathogenesis is unknown and there is no established treatment. There have been case reports on the efficacy of intravenous immunoglobulin (IVIG).4 5 Postulated mech-anisms include reduction of myelinotoxic agents, development of antimyelin antibodies, and promotion of remyelination.4 We report a case of CPM associated with chronic alcoholism and hyponatremia, with significant clinical improvement and resolution of MRI changes after treatment with IVIG.