Central pontine myelinolysis: Difference between revisions
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{{Infobox medical condition | |||
| name = Central pontine myelinolysis | |||
| image = [[File:MRI_Central_Pontine_Myelinolysis_fat_sat_T2.jpg|left|thumb|MRI of Central Pontine Myelinolysis]] | |||
| caption = MRI showing Central Pontine Myelinolysis | |||
| field = [[Neurology]] | |||
| synonyms = Osmotic demyelination syndrome | |||
| symptoms = [[Confusion]], [[paralysis]], [[dysarthria]], [[dysphagia]], [[coma]] | |||
| complications = [[Locked-in syndrome]], [[death]] | |||
| onset = Rapid | |||
| duration = Variable | |||
| causes = Rapid correction of [[hyponatremia]] | |||
| risks = [[Alcoholism]], [[malnutrition]], [[liver disease]], [[burns]], [[electrolyte imbalance]] | |||
| diagnosis = [[Magnetic resonance imaging|MRI]] | |||
| differential = [[Multiple sclerosis]], [[stroke]], [[encephalitis]] | |||
| treatment = Supportive care, prevention of rapid sodium correction | |||
| prognosis = Variable, can be severe | |||
| frequency = Rare | |||
}} | |||
Central Pontine Myelinolysis | Central Pontine Myelinolysis | ||
'''Central Pontine Myelinolysis''' (CPM) is a neurological disorder characterized by the destruction of the myelin sheath in the central part of the [[pons]], a structure located in the [[brainstem]]. This condition is often associated with the rapid correction of [[hyponatremia]], a condition where there is a low concentration of sodium in the blood. | '''Central Pontine Myelinolysis''' (CPM) is a neurological disorder characterized by the destruction of the myelin sheath in the central part of the [[pons]], a structure located in the [[brainstem]]. This condition is often associated with the rapid correction of [[hyponatremia]], a condition where there is a low concentration of sodium in the blood. | ||
==Pathophysiology== | ==Pathophysiology== | ||
Central Pontine Myelinolysis occurs when there is a rapid shift in the [[osmotic balance]] of the brain, particularly affecting the [[pons]]. The myelin sheath, which insulates [[nerve fibers]] and facilitates the transmission of [[nerve impulses]], becomes damaged. This demyelination disrupts normal neurological function. | Central Pontine Myelinolysis occurs when there is a rapid shift in the [[osmotic balance]] of the brain, particularly affecting the [[pons]]. The myelin sheath, which insulates [[nerve fibers]] and facilitates the transmission of [[nerve impulses]], becomes damaged. This demyelination disrupts normal neurological function. | ||
==Causes== | ==Causes== | ||
The primary cause of Central Pontine Myelinolysis is the rapid correction of [[hyponatremia]]. When sodium levels in the blood are increased too quickly, it can lead to osmotic stress and damage to the myelin in the pons. Other potential causes include: | The primary cause of Central Pontine Myelinolysis is the rapid correction of [[hyponatremia]]. When sodium levels in the blood are increased too quickly, it can lead to osmotic stress and damage to the myelin in the pons. Other potential causes include: | ||
| Line 13: | Line 29: | ||
* [[Burns]] | * [[Burns]] | ||
* [[Electrolyte imbalances]] | * [[Electrolyte imbalances]] | ||
==Symptoms== | ==Symptoms== | ||
Symptoms of Central Pontine Myelinolysis can vary but often include: | Symptoms of Central Pontine Myelinolysis can vary but often include: | ||
| Line 21: | Line 36: | ||
* [[Confusion]] | * [[Confusion]] | ||
* [[Coma]] | * [[Coma]] | ||
==Diagnosis== | ==Diagnosis== | ||
Diagnosis of Central Pontine Myelinolysis is typically made through [[magnetic resonance imaging]] (MRI) of the brain, which can reveal characteristic changes in the pons. Clinical history and laboratory tests to assess sodium levels are also important. | Diagnosis of Central Pontine Myelinolysis is typically made through [[magnetic resonance imaging]] (MRI) of the brain, which can reveal characteristic changes in the pons. Clinical history and laboratory tests to assess sodium levels are also important. | ||
==Treatment== | ==Treatment== | ||
There is no specific treatment for Central Pontine Myelinolysis. Management focuses on supportive care and addressing the underlying cause of the condition. Preventing rapid correction of hyponatremia is crucial. | There is no specific treatment for Central Pontine Myelinolysis. Management focuses on supportive care and addressing the underlying cause of the condition. Preventing rapid correction of hyponatremia is crucial. | ||
==Prognosis== | ==Prognosis== | ||
The prognosis for individuals with Central Pontine Myelinolysis varies. Some patients may recover fully, while others may experience long-term neurological deficits. Early recognition and careful management of sodium levels can improve outcomes. | The prognosis for individuals with Central Pontine Myelinolysis varies. Some patients may recover fully, while others may experience long-term neurological deficits. Early recognition and careful management of sodium levels can improve outcomes. | ||
==Prevention== | ==Prevention== | ||
Preventing Central Pontine Myelinolysis involves careful management of [[electrolyte imbalances]], particularly avoiding rapid correction of hyponatremia. Monitoring and adjusting sodium levels gradually can help prevent this condition. | Preventing Central Pontine Myelinolysis involves careful management of [[electrolyte imbalances]], particularly avoiding rapid correction of hyponatremia. Monitoring and adjusting sodium levels gradually can help prevent this condition. | ||
==Gallery== | |||
<gallery> | |||
File:Extrapontine myelinolysis T2 01.jpg|Extrapontine myelinolysis | |||
File:Pontine myelinolysis.jpg|Pontine myelinolysis | |||
</gallery> | |||
==See Also== | ==See Also== | ||
* [[Hyponatremia]] | * [[Hyponatremia]] | ||
* [[Demyelinating disease]] | * [[Demyelinating disease]] | ||
* [[Brainstem]] | * [[Brainstem]] | ||
==External Links== | ==External Links== | ||
* [Central Pontine Myelinolysis on Wikipedia](https://en.wikipedia.org/wiki/Central_pontine_myelinolysis) | * [Central Pontine Myelinolysis on Wikipedia](https://en.wikipedia.org/wiki/Central_pontine_myelinolysis) | ||
{{Neurology}} | {{Neurology}} | ||
{{Brain disorders}} | {{Brain disorders}} | ||
[[Category:Neurology]] | [[Category:Neurology]] | ||
[[Category:Brain disorders]] | [[Category:Brain disorders]] | ||
[[Category:Demyelinating diseases]] | [[Category:Demyelinating diseases]] | ||
Latest revision as of 21:42, 4 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Central pontine myelinolysis | |
|---|---|
 | |
| Synonyms | Osmotic demyelination syndrome |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Confusion, paralysis, dysarthria, dysphagia, coma |
| Complications | Locked-in syndrome, death |
| Onset | Rapid |
| Duration | Variable |
| Types | N/A |
| Causes | Rapid correction of hyponatremia |
| Risks | Alcoholism, malnutrition, liver disease, burns, electrolyte imbalance |
| Diagnosis | MRI |
| Differential diagnosis | Multiple sclerosis, stroke, encephalitis |
| Prevention | N/A |
| Treatment | Supportive care, prevention of rapid sodium correction |
| Medication | N/A |
| Prognosis | Variable, can be severe |
| Frequency | Rare |
| Deaths | N/A |
Central Pontine Myelinolysis
Central Pontine Myelinolysis (CPM) is a neurological disorder characterized by the destruction of the myelin sheath in the central part of the pons, a structure located in the brainstem. This condition is often associated with the rapid correction of hyponatremia, a condition where there is a low concentration of sodium in the blood.
Pathophysiology
Central Pontine Myelinolysis occurs when there is a rapid shift in the osmotic balance of the brain, particularly affecting the pons. The myelin sheath, which insulates nerve fibers and facilitates the transmission of nerve impulses, becomes damaged. This demyelination disrupts normal neurological function.
Causes
The primary cause of Central Pontine Myelinolysis is the rapid correction of hyponatremia. When sodium levels in the blood are increased too quickly, it can lead to osmotic stress and damage to the myelin in the pons. Other potential causes include:
Symptoms
Symptoms of Central Pontine Myelinolysis can vary but often include:
- Dysarthria (difficulty speaking)
- Dysphagia (difficulty swallowing)
- Quadriparesis (weakness in all four limbs)
- Confusion
- Coma
Diagnosis
Diagnosis of Central Pontine Myelinolysis is typically made through magnetic resonance imaging (MRI) of the brain, which can reveal characteristic changes in the pons. Clinical history and laboratory tests to assess sodium levels are also important.
Treatment
There is no specific treatment for Central Pontine Myelinolysis. Management focuses on supportive care and addressing the underlying cause of the condition. Preventing rapid correction of hyponatremia is crucial.
Prognosis
The prognosis for individuals with Central Pontine Myelinolysis varies. Some patients may recover fully, while others may experience long-term neurological deficits. Early recognition and careful management of sodium levels can improve outcomes.
Prevention
Preventing Central Pontine Myelinolysis involves careful management of electrolyte imbalances, particularly avoiding rapid correction of hyponatremia. Monitoring and adjusting sodium levels gradually can help prevent this condition.
Gallery
-
Extrapontine myelinolysis -
Pontine myelinolysis
See Also
External Links
- [Central Pontine Myelinolysis on Wikipedia](https://en.wikipedia.org/wiki/Central_pontine_myelinolysis)
WikiMD neurology
External links
- Comprehensive information from the National Institute of health.
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