Patients with central pontine myelinolysis may have a positive history of: Malnutrition, alcohol use disorder, chronic liver disease, hyperemesis gravidarum, hypophosphatemia secondary to refeeding syndrome and prolonged ischemia. These patients with central pontine myelinolysis most commonly have a history of rapid sodium correction, greater than 0.5-1.0 mEq/L per hour. The most susceptible patients are those with: Chronic hyponatremia (>48 hours), severe hyponatremia (Na <120 mEq/L) and both chronic hyponatremia and severe hyponatremia. Common symptoms of central pontine myelinolysis include: Spastic quadriparesis, dysarthria, pseudobulbar palsy and altered mental status. In some patients, parkinsonian features, behavioral manifestations, and neuropsychological symptoms can also be present: Personality changes, labile affect, disinhibition, poor judgment, paranoid delusions, emotional lability, delirium, hallucinations and catatonia.

Patients with central pontine myelinolysis may have a positive history of:^[1][2][3]

• Malnutrition
• Alcohol use disorder
• Chronic liver disease
• Hyperemesis gravidarum
• Hypophosphatemia secondary to refeeding syndrome
• Prolonged ischemia

These patients with central pontine myelinolysis most commonly have a history of rapid sodium correction, greater than 0.5-1.0 mEq/L per hour.

The most susceptible patients are those with:^[1]

• Chronic hyponatremia (>48 hours)

• Severe hyponatremia (Na <120 mEq/L)
• Both chronic hyponatremia and severe hyponatremia

Common symptoms of central pontine myelinolysis include:^[1][2][3][4]

• Spastic quadriparesis
• Dysarthria
• Pseudobulbar palsy
• Altered mental status

In some patients, parkinsonian features, behavioral manifestations, and neuropsychological symptoms can also be present:^[4][5]

• Personality changes
• Labile affect
• Disinhibition
• Poor judgment
• Paranoid delusions
• Emotional lability
• Delirium
• Hallucinations
• Catatonia