Central pontine myelinolysis

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It has been suggested that this article or section be merged with Osmotic demyelination syndrome. (Discuss)

Central pontine myelinolysis Classification and external resources
Pons labeled at bottom left
ICD-10	G37.2
DiseasesDB	2198
MedlinePlus	000775
eMedicine	neuro/50
MeSH	D017590

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.

Contents 1 Causes 2 Diagnosis 3 Symptoms 4 Treatment 5 References 6 External Links

[edit] Causes

The most common cause is the rapid correction of low blood sodium levels (hyponatremia).

[edit] Diagnosis

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, double vision 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

To avoid myelinolysis, the correction of hyponatremia should not exceed 1 mEq/L per hour. ^[1][2]

[edit] References

1. ^ Kleinschmidt-DeMasters BK, Norenberg MD. Rapid correction of hyponatremia causes demyelination: relation to central pontine myelinolysis. Science. 1981;211(4486):1068-70. PMID 7466381
2. ^ Laureno R. Experimental pontine and extrapontine myelinolysis. Trans Am Neurol Assoc. 1980;105:354-8. PMID 7348981

• Gocht A , Colmant HJ. Central pontine and extrapontine myelinolysis: a report of 58 cases. Clin Neuropath. 1987;6:262–70. PMID 3322623

• Menger H , Jorg J. Outcome of central pontine and extrapontine myelinolysis (n=44). J Neurol. 1999;246:700–5. PMID 10460448

v • d • e Pathology of the nervous system, primarily CNS (G00-G47, 320-349) Inflammatory diseases of the CNS Meningitis (Arachnoiditis) - Encephalitis - Myelitis - Encephalomyelitis (Acute disseminated) - Tropical spastic paraparesis - Cavernous sinus thrombosis Systemic atrophies primarily affecting the CNS Huntington's Spinocerebellar ataxia (Friedreich's ataxia, Ataxia telangiectasia, Hereditary spastic paraplegia) Spinal muscular atrophy: Werdnig-Hoffman - Kugelberg-Welander - Fazio Londe - MND (ALS, PMA, PBP, PP, PLS) Extrapyramidal and movement disorders Parkinson's disease - Neuroleptic malignant syndrome - Postencephalitic parkinsonism - Pantothenate kinase-associated neurodegeneration - Progressive supranuclear palsy - Striatonigral degeneration Dystonia/Dyskinesia (Spasmodic torticollis, Meige's, Blepharospasm) Essential tremor - Myoclonus - Lafora Chorea (Choreoathetosis) - Restless legs - Stiff person Other degenerative/ demyelinating diseases dementia: Alzheimer's - Pick's - Dementia with Lewy bodies - Frontotemporal lobar degeneration mitochondrial disease: Leigh's demyelinating: Multiple sclerosis - Devic's - Central pontine myelinolysis - Transverse myelitis - Marchiafava-Bignami disease - CAMFAK syndrome - Alpers' Seizure/epilepsy Focal (Simple partial, Complex partial) - Generalised (Tonic-clonic, Absence, Atonic, Benign familial neonatal) Lennox-Gastaut - West - Epilepsia partialis continua - Status epilepticus (Complex partial status epilepticus) Headache Migraine (Familial hemiplegic) - Cluster - Vascular - Tension Vascular Transient ischemic attack (Amaurosis fugax, Transient global amnesia) Cerebrovascular disease (MCA, ACA, PCA, Foville's, Millard-Gubler, Lateral medullary, Weber's, Lacunar stroke) Sleep disorders Insomnia - Hypersomnia - Sleep apnea (Ondine's curse) - Narcolepsy - Cataplexy - Kleine-Levin - Circadian rhythm sleep - Delayed sleep phase - Advanced sleep phase Intracranial hypertension Hydrocephalus (Normal pressure) - Idiopathic intracranial hypertension Other encephalopathy Brain herniation - Cerebral edema - Reye's Other spinal cord disease Syringomyelia - Syringobulbia - Morvan's syndrome - Spinal cord compression

[edit] External Links

MedPix Images of Osmotic Myelinolysis