What causes Extrapontine Myelinolysis?
What causes central pontine myelinolysis? The most frequent cause of central pontine myelinolysis is a rapid increase in sodium levels. This can happen during treatment to correct low sodium levels (hyponatremia). Sodium is an important electrolyte in your body and helps maintain fluid balance in your cells.
Is osmotic demyelination syndrome the same as central pontine myelinolysis?
The neurologic manifestations associated with overly rapid correction have been called the osmotic demyelination syndrome (ODS; formerly called central pontine myelinolysis or CPM). As will be described below, almost all patients who develop ODS present with a serum sodium concentration of 120 mEq/L or less.
How do you correct central pontine myelinolysis?
There is no known cure for central pontine myelinolysis. Treatment is focused on relieving symptoms. Physical therapy may help maintain muscle strength, mobility, and function in weakened arms and legs.
Can central pontine myelinolysis be reversed?
The disorder can’t be cured, but its symptoms can be treated. CPM is one of the two types of osmotic demyelination syndrome (ODS). The other type, known as extrapontine myelinosis (EPM), occurs when myelin is destroyed in areas of the brain that aren’t in the brain stem.
Is CPM reversible?
Similarly to prior CPM case reports, this patient significantly improved following reinduction of hyponatremia, methylprednisolone, and/or plasmapharesis. This report demonstrates that CPM is potentially reversible when quickly recognized and therapeutic interventions are initiated rapidly.
What causes osmotic demyelination syndrome?
The most common cause of ODS is a quick change in the body’s sodium levels. This most often occurs when someone is being treated for low blood sodium (hyponatremia) and the sodium is replaced too fast. Sometimes, it occurs when a high level of sodium in the body (hypernatremia) is corrected too quickly.
What happens if you give sodium too quickly?
Too-rapid correction of sodium can cause osmotic demyelination syndrome (ODS), a form of brain damage.
Is pontine demyelination reversible?
This report demonstrates that CPM is potentially reversible when quickly recognized and therapeutic interventions are initiated rapidly.
How long does it take to develop central pontine myelinolysis?
The initial symptoms of myelinolysis, which begin to appear 2 to 3 days after hyponatremia is corrected, include a depressed level of awareness, difficulty speaking (dysarthria or mutism), and difficulty swallowing (dysphagia).
What happens if you replace sodium too fast?
Can alcohol cause central pontine myelinolysis?
CPM is attributed to rapid fluctuations in electrolyte status, usually in the context of a hospitalization. About 2% of persons with liver transplant develop central pontine myelinolysis. Some cases of CPM appear to be triggered solely by alcohol withdrawal (Yoon et al, 2008).
How do I know if I have osmotic demyelination syndrome?
A head MRI scan may reveal a problem in the brainstem (pons) or other parts of the brain. This is the main diagnostic test. Other tests may include: Blood sodium level and other blood tests.