Central pontine myelinolysis (CPM), a disorder occurring for the most part in alcohol abusers, is characterized by the symmetric and selective destruction of medullated sheaths in the central pontine region. Detection of CPM in the pre-symptomatic phase may improve the outcome, which is usually serious. We describe a case of CPM in a 48-year-old female alcohol abuser who was seen at our out-patient clinic for a history of generalized seizures. Neurological examination was normal while magnetic resonance imaging revealed a pontine lesion consistent with CPM. On the basis of this report we hypothesize that the possibility to detect CPM in the pre-symptomatic phase will lead to increased diffusion of magnetic resonance imaging, and in turn to improved therapeutic strategies, such as the use of greater caution when correcting plasma electrolyte imbalance in alcoholics.