Introduction: Central pontine myelinolysis (CPM) is a well-recognized syndrome that is related to various conditions such as rapid correction of hyponatremia and chronic alcoholism.

Case Report: We report a case of a recently discharged patient with dysarthria, vertigo, and progressive gait changes, with radiological evidence of CPM, but without the expected rapid correction of hyponatremia seen in other patients that developed CPM.

Conclusion: CPM is rare without severe hyponatremia of 120 meq/L or less, but there are other factors that contribute to the development of CPM, that may be unrelated to hyponatremia. Severe alcohol abuse, acute pancreatitis, and subsequent poor nutritional intake were likely the major factors in inducing osmotic injury in this case, which lead to CPM.

Keywords: Alcoholism, Central pontine myelinolysis, Hyponatremia, Osmotic demyelination syndrome, Pancreatitis