central pontine myelinolysis


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cen·tral pon·tine my·e·li·nol·y·sis

a sporadic disorder characterized by a localized area of demyelination in the center of the basis pontis that, on cross section, can vary substantially in size from one patient to another. In most instances, occurs concurrently with some other serious medical disorder (for example, chronic alcoholism, severe burns, advanced lymphomas); clinically may be asymptomatic or markedly symptomatic, depending on the size of the lesion.

central pontine myelinolysis

A condition characterised by softening of the base of the brain at the pons with damage to the myelin sheath, related to aggressive correction of hyponatraemia. First identified in alcoholics (Wernicke-Korsakoff syndrome), CPM also occurs in AIDS, infection, lymphoproliferative disorders (e.g., AML), malnutrition, and post-stem cell transplantation venous obstruction.
 
Clinical findings
Weakness, double vision, muscle spasms, speech defects, delirium, sleep disorders, hallucinations, tremors and uncontrolled eye movements.
 
Imaging
Defects by MRI.

Prevention
Slow correction of electrolytic imbalance.

central pontine myelinolysis

Neuropathology A condition characterized by softening of the base of the brain at the pons with damage to the myelin sheath, related to aggressive correction of hyponatremia; first identified in alcoholics–Wernicke-Korsakoff syndrome, CPM also occurs in AIDS, infection, lymphoproliferative disorders–eg, AML, malnutrition, and venous obstruction Clinical Weakness, double vision, muscle spasms, speech defects, delirium, sleep disorders, hallucinations, tremors and uncontrolled eye movements Imaging Defects are seen by MRI Prevention Slow correction of electrolytic imbalance.

central pontine myelinolysis

A rare disorder featuring an area of severe loss of myelin in nerve fibres running through the middle of the PONS in the brainstem. There is progressive failure of verbal articulation (dysarthria) and spastic paralysis in all four limbs (quadriplegia). The condition may occur in alcoholism, liver disease, kidney failure and rapid correction of severe sodium depletion.
References in periodicals archive ?
Demyelination of the lateral geniculate nucleus in central pontine myelinolysis.
Clinical and radiologic correlations of central pontine myelinolysis syndrome.
Central pontine myelinolysis following slow correction of hyponatremia.
Improvement of central pontine myelinolysis as demonstrated by repeated magnetic resonance imaging in a patient without evidence of hyponatremia.
Central pontine myelinolysis is not associated with enhancement or significant mass effect.
Complete recovery of central pontine myelinolysis by high dose pulse therapy with methylprednisolone].
The most serious potential complication is central pontine myelinolysis (CPM).
MRI of the brain without contrast reveals restricted diffusion in the pons centrally, with extension bilaterally to the midbrain and thalami--findings consistent with central pontine myelinolysis.
Other causes include haemorrhage, tumour, trauma, central pontine myelinolysis, pontine abscess, interscalene brachial plexus blocks and postinfective polyneuropathy.
If too rapid correction of serum sodium occurs, the patient is placed at risk for developing central pontine myelinolysis (Braunwald et al.
2) weighted images suggestive of central pontine myelinolysis.
Diffusion weighted image shows restricted diffusion of the described lesion suggesting cytotoxic edema rather than vasogenic confirming the diagnosis of central pontine myelinolysis.

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