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SWPA States

A Case Study of Central Pontine Myelinolysis Co-Morbid with Alcohol Abuse
    Chelsi King     California School of Professional Psychology at Alliant International University, Fresno
    Sandra Isabel Viggiani     Fuller School of Psychology, Fuller Seminary
    Katherine Hippman     Louisiana State University Baton Rouge LA
    Billie Clare Myers     Fielding Graduate University
    Kimberly S. Hutchinson     Lake Charles Memorial Hospital
    Lawrence S Dilks     Counseling Services
    Burton Ashworth     Counseling Services
    Marnie Richard     Hawaii School of Professional Psychology


Introduction
Central Pontine Myelinolysis (CPM), is neurological disorder caused by brain cell dysfunction. Essentially, CPM is caused by the destruction of myelin sheath (covering) on nerve cells in the Pons area in the brainstem. A common cause of CPM is rapid change in sodium levels in the body. Risk factors include the following: alcoholism, liver disease, and malnutrition. Previous literature suggest individuals who are diagnosed with CPM demonstrate the following symptoms: confusion, delirium, poor alertness, lethargy hallucinations, difficulty swallowing, changes in speech, problems with balance, tremors, and bilateral weakness in face, arms, or legs.

Method
A case study was conducted on a 55 year old, female patient who diagnosed with CPM and past history of alcohol abuse. She reported history of panic attacks and endorsed symptoms consistent with anxiety. An abbreviated neuropsychological test battery and mental status evaluation were conducted with the patient.

Results
Her mental status was intact. She was alert and coherent and oriented in all spheres. Thought processing was slowed. She denied any history of delusions, hallucinations, or perceptual disturbances. None were apparent during the course of the evaluation. Patient presented with mild speech dysfluency; her speech was slurred. She demonstrated significant anxiety during the evaluation often displayed by fidgetiness. Fine and gross motor abilities were moderately impaired by overall weakness in the patientís extremities. Neuropsychological test results suggested the patientís intellectual abilities were in the average range. Moderate impairment was found in the patientís executive functioning abilities including visual tracking, visual scanning and acuity, processing speed, and cognitive shifting and flexibility. Language impairment was also identified by testing with regard to semantic fluency. She scored in the below-average range. Patient endorsed significant anxiety symptoms during the course of evaluation. She met diagnostic criteria for Mild Neurocognitive Disorder due to Another Medical Condition and Unspecified Anxiety Disorder.

Discussion
Implications suggest further research investigate the association between CPM and anxiety as well as further explore the relationship between CPM and deficits in executive functioning and language.





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