Aetiology

• 2-6 days following rapid correction of Hyponatremia or rapid changes in osmolality.
• also chronic alcoholism, malnutrition etc.

Pathogenesis

rapid correction → Myelinolysis in the base of Pons. No inflammation.

Clinical features

• Rapidly evolving quadriplegia, may be fatal
• Locked in syndrome: fully conscious yet unresponsive patients.
• central pontine myelinolysis