Oneliner_459

OneLiner

History of alcohol abuse with new-onset pseudobulbar palsy (dysarthria, dysphagia, dysphonia) and quadriparesis suggesting brainstem insult -> focal, symmetric demyelination of the pons -> osmotic demyelination syndrome (ODS) aka central pontine myelinolysis. May present with horizontal gaze paralysis, obtundation, “locked in” syndrome