Central pontine myelinolysis in a patient with bulimia.

Central pontine myelinolysis is classically described in alcoholics or other malnourished individuals after correction of severe hyponatremia. A patient with bulimia developed central pontine myelinolysis after correction of severe hyponatremia and hypokalemia. Early symptoms of abnormal affect and dystonia made initial diagnosis elusive. The spectrum of neurologic signs and possible causes of central pontine myelinolysis are discussed. A conservative approach to treatment of hyponatremia is advocated.