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 ?
It is possible that our patient developed these neurologic sequalae due to combination of prolonged cerebral edema and central pontine myelinolysis. It is unclear if our patient developed these complications due to severity of illness, therapies administered, or a combination of these elements.
Demyelination of the lateral geniculate nucleus in central pontine myelinolysis. Annals of Neurology 9(2):185-189, 1981.
Mesulam, "Behavioral manifestations of central pontine myelinolysis," Archives of Neurology, vol.
Therefore, both extra pontine and central pontine myelinolysis can occur as a consequence of a rapid correction of hyponatremia in individuals with chronic, severe hyponatraemia [45].
"Man-in-the-barrel" syndrome as delayed manifestation of extrapontine and central pontine myelinolysis: beneficial effect of intravenous immunoglobulin.
Central pontine myelinolysis (CPM), steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), Bickerstaff's brainstem encephalitis (BBE) are some of the disorders that might present with a localized lesion that specifically involves the pontine area (3).
The correction of hyponatraemia carries the risk of osmotic demyelination, better known as central pontine myelinolysis (CPM), although the demyelination is not necessarily confined to the pons.
A drawback to using HTS in the resuscitation phase is that clinicians need to know the patient's serum sodium levels before initiating HTS therapy If the initial serum sodium level is 130 mmol/L or lower, a rapid increase could cause central pontine myelinolysis, a devastating complication.
Osmotic demyelination, or central pontine myelinolysis, in association with the rapid correction of an acute hyponatremia (ie, <48 hour duration), has not been reported (86) and should never be an impediment to rapidly correcting hyponatremia in symptomatic EAH (7,21-23,26,43,46,54,60).
Lastly, chronic alcohol consumption can lead to specific neurological disorders involving white matter, such as Marchiafava--Bignami disease and central pontine myelinolysis (Charness 1993).
Wernicke's encephalopathy and central pontine myelinolysis associated with hyperemesis gravidarum.

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