Central pontine myelinolysis is a type of osmotic demyelination syndrome and was first described by Adams and Victor in 1959. Osmotic demyelination syndrome has been reported to occur most commonly in men between the ages of 30 and 60 years, with a prevalence of 0.25% to 0.5% in the general population. Demyelination usually occurs in the areas of the brain with the slowest osmotic uptake, with the most common sites including the central pontine (30%-50%), extra-pontine areas, or both central pontine and extra-pontine areas. Common sites outside the pons include the cerebellum, lateral geniculate body, hippocampus, cerebral cortex, thalamus, caudate nucleus, internal capsule, midbrain, and mammillary bodies. The etiology of central pontine myelinolysis includes chronic alcoholism, history of liver transplantation, rapid correction of hyponatremia, and malnutrition. Approximately 2-6 days after rapid elevation of serum sodium levels, patients may present with Parkinson’s disease, tetraplegia, atresia syndrome, coma, bulbar palsy, and less commonly, dysphagia, dysarthria, facial palsy, ataxia, nystagmus, drowsiness, and confusion. Symptoms and imaging manifestations can be delayed for up to 16 days. a negative MRI does not exclude pontocerebral central myelinolysis, and the head MRI should be reviewed at 15 days if the disease is highly suspected clinically. The clinical presentation of pontocerebral central myelinolysis is varied and can be easily misdiagnosed or missed, and missed treatment is one of the reasons for the poor prognosis of the disease. Patients who have a recent history of malnutrition or chronic wasting disease should think about the possibility of the disease. Early detection and timely treatment of the disease is important, with high-dose hormone shock, intravenous gammaglobulin, dehydration, hyperbaric oxygen and other treatments, in addition to the need to treat the original disease, supplementation of B vitamins and nutritional support will be beneficial to the prognosis.