Central pontine myelinolysis
From Psychology Wiki
Community portal · Tasks to do · News · Help
Clinical · Educational · Ind&Org · Other fields · Professional · Transpersonal · World
Assessment |
Biopsychology |
Comparative |
Cognitive |
Developmental |
Language
Personality |
Philosophy |
Research Methods |
Social |
Statistics
Clinical: Approaches · Group therapy · Techniques · Types of problem · Areas of specialism · Taxonomies · Therapeutic issues · Modes of delivery · Model translation project · Personal experiences ·
| ICD-10 | G372 | |
|---|---|---|
| ICD-9 | ||
| OMIM | [1] | |
| DiseasesDB | 2198 | |
| MedlinePlus | 000775 | |
| eMedicine | neuro/50 | |
| MeSH | {{{MeshNumber}}} | |
Central pontine myelinolysis is a neurologic disease caused by severe damage of the myelin sheath of nerve cells in the brainstem, more precisely in the area termed the pons.
It can also occur outside the pons.[1] The term "osmotic demyelinization syndrome" is similar to "central pontine myelinolysis", but also includes areas outside the pons.[2]
Contents |
[edit] Causes
The most common cause is the rapid correction of low blood sodium levels (hyponatremia).[3]
It has been observed following hematopoietic stem cell transplantation.[4]
It is frequently associated with alcoholism.[5]
[edit] Diagnosis
It can be difficult to identify using conventional imaging techniques.[6]
Imaging by MRI demonstrates an area of high signal return on T2 weighted images.
[edit] Symptoms
Frequently observed symptoms in this disorder are sudden para or quadraparesis, dysphagia, dysarthria, diplopia and loss of consciousness. The patient may experience locked-in syndrome where cognitive function is intact, but all muscles are paralyzed with the exception of eye blinking.
[edit] Treatment
Treatment is supportive only.
Correct hyponatremia at a rate of 10 µmol/L/24 h; diligently avoid hypernatremia. Details concerning the etiology and correction of electrolyte disorders are discussed extensively in general medicine texts. Alcoholic patients should receive vitamin supplementation. Formally evaluate their nutritional status. [7][8]
[edit] Additional images
CPM3.jpg
Central pontine myelinolysis, MRI FLAIR |
Epm.jpg
T2 weighted magnetic resonance scan image showing bilaterally symmetrical hyperintensities in Caudate nucleus (small, thin arrow), Putamen (long arrow), with sparing of Globus Pallidus (broad arrow), suggestive of Extrapontine myelinolysis. |
[edit] References
- ↑ Gocht A, Colmant HJ (1987). Central pontine and extrapontine myelinolysis: a report of 58 cases. Clin. Neuropathol. 6 (6): 262–70.
- ↑ Lampl C, Yazdi K (2002). Central pontine myelinolysis. Eur. Neurol. 47 (1): 3–10.
- ↑ Bernsen HJ, Prick MJ (September 1999). Improvement of central pontine myelinolysis as demonstrated by repeated magnetic resonance imaging in a patient without evidence of hyponatremia. Acta Neurol Belg 99 (3): 189–93.
- ↑ Lim KH, Kim S, Lee YS, et al (April 2008). Central pontine myelinolysis in a patient with acute lymphoblastic leukemia after hematopoietic stem cell transplantation: a case report. J. Korean Med. Sci. 23 (2): 324–7.
- ↑ Menger H, Jörg J (August 1999). Outcome of central pontine and extrapontine myelinolysis (n = 44). J. Neurol. 246 (8): 700–5.
- ↑ Ruzek KA, Campeau NG, Miller GM (February 2004). Early diagnosis of central pontine myelinolysis with diffusion-weighted imaging. AJNR Am J Neuroradiol 25 (2): 210–3.
- ↑ Kleinschmidt-DeMasters BK, Norenberg MD. Rapid correction of hyponatremia causes demyelination: relation to central pontine myelinolysis. Science. 1981;211(4486):1068-70. PMID 7466381
- ↑ Laureno R. Experimental pontine and extrapontine myelinolysis. Trans Am Neurol Assoc. 1980;105:354-8. PMID 7348981
[edit] External links
- MedPix Images of Osmotic Myelinolysis
| This page uses content from the English-language version of Wikipedia. The original article was at Central pontine myelinolysis. The list of authors can be seen in the page history. As with Psychology Wiki, the text of Wikipedia is available under the GNU Free Documentation License. |
