Since the first description of the central myelinolytic lesion of the pons by Adams et al in 1959,1and aptly named "central pontine myelinolysis" (CPM), an increasing number of cases have been reported in the literature. We know of 66 different cases that have been recorded to date.1-30 Adams et al1described the clinical features observed in three of their four patients. One patient was thought not to have demonstrated symptoms, because his lesion was small. Chronic alcoholism or malnutrition or both, with the appearance of quadriparesis, bulbar disorders, pathological reflexes, pseudobulbar emotionality, incontinence, decreased alertness, and confusion dominated the clinical picture. The majority of the subsequently reported patients have manifested similar features. Three additional patients with CPM have recently been studied at this institution, two of whom were found during the routine gross neuropathological examination. The other case was found after we had directed our search