Article
Neurosciences
Yu Chia Liu, Yen Kuang Yang, Po See Chen, Wei Hung Chang
Summary: A 76-year-old male presented with a recurrent depressive episode, an unsteady gait, and cognitive impairment. MRI showed the typical feature of central pontine myelinolysis (CPM), which could possibly be related to the chronic use of venlafaxine for treating major depressive disorder.
CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE
(2021)
Article
Clinical Neurology
Hui-Ling Qu, Xiao-Yu Sun, Ying-Jie Dai
Summary: In this study, we present a unique case of a 46-year-old man with a hyperglycemic state complicated with central pontine myelinolysis (CPM), a heterogeneous nervous system disease caused by rapid correction of hyponatremia. MRI showed a high signal on T2 and symmetric restricted diffusion in the pontine region. This clinical case confirms that the hyperosmolar state inherent in hyperglycemia is a likely cause of CPM.
FRONTIERS IN NEUROLOGY
(2023)
Article
Clinical Neurology
Guillaume Lamotte
Summary: Central pontine myelinolysis (CPM) is a neurological disorder caused by rapid correction of serum sodium levels in patients with chronic hyponatremia. It is recommended to increase plasma sodium concentration by no more than 8 to 10 mmol/L per 24 h in patients with chronic hyponatremia.
NEUROLOGICAL SCIENCES
(2021)
Article
Medicine, General & Internal
Xiao-Yong Shi, Meng-Ting Cai, Hao Shen, Jin-Xia Zhang
Summary: Diabetes can rarely lead to CPM, and patients can benefit from corticosteroid treatment. Clinicians should be aware of the relationship between diabetes and CPM and act early for appropriate treatment.
WORLD JOURNAL OF CLINICAL CASES
(2021)
Article
Medicine, General & Internal
Wasey Ali Yadullahi Mir, Dhan B. Shrestha, Barun B. Aryal, Vijay K. Reddy, Mir Arshad Ali Yadullahi
Summary: CPM is a neurological disorder typically caused by rapid correction of severe chronic hyponatremia. This case describes a patient with uncontrolled diabetes mellitus presenting symptoms of CPM in the presence of normal serum sodium. Timely treatment of hyperglycemia can lead to symptom improvement, but CPM is a potentially fatal condition.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2021)
Review
Medicine, General & Internal
Ceren Erkalayci, Leyla Ramazanoglu, Eren Gozke
Summary: The diagnosis of central pontine hyperintensities on cranial magnetic resonance imaging can have various clinical presentations and etiologies, not limited to rapid correction of hyponatremia. It is crucial to consider different diagnoses and factors when diagnosing central pontine myelinolysis.
IRISH JOURNAL OF MEDICAL SCIENCE
(2023)
Article
Endocrinology & Metabolism
Wen-Ping Sun, Ying-Di Wang, Song Gao, Yi-Fan Wang, Da-Wei Li
Summary: This article reports a case of central pontine myelinolysis (CPM) in a Chinese male, a rare demyelinating disorder characterized by the loss of myelin in the center of the basis pontis. The patient, a 66-year-old, presented with symptoms of gait imbalance, mild slurred speech, and dysphagia, and MRI revealed mass lesions in the brainstem. Laboratory examinations showed high blood glucose, HbA1c, and increased serum osmolality. The patient was diagnosed with CPM secondary to hyperosmolar hyperglycemia and received insulin treatment and supportive therapy. After six weeks of follow-up, the patient fully recovered to a normal state.
BMC ENDOCRINE DISORDERS
(2023)
Article
Medicine, General & Internal
Abhinav Dahal, Ayush Mohan Bhattarai, Ashish Mohan Bhattarai, Bishnu Deep Pathak, Abinash Karki, Egesh Aryal
Summary: Central pontine myelinolysis is a demyelination syndrome that primarily affects the pons, and it is commonly caused by rapid correction of hyponatremia. We present a case of a 44-year-old male with a history of chronic alcohol consumption, who exhibited symptoms of slurred speech and weakness in all four limbs. The patient's MRI scan showed a trident-shaped appearance with abnormal T2W/FLAIR signal in the pons, while the periphery appeared relatively normal. The patient was managed conservatively.
ANNALS OF MEDICINE AND SURGERY
(2022)
Review
Clinical Neurology
Stefania Kalampokini, Artemios Artemiadis, Panagiotis Zis, Linos Hadjihannas, Giorgos Parpas, Artemis Kyrri, Georgios M. Hadjigeorgiou
Summary: Immunoglobulin showed significant improvement in ODS treatment, while the efficacy of steroids remains unclear and plasmapheresis has shown favorable outcomes at various follow-up times. Therapeutic choices should be considered based on the severity of the disease.
CLINICAL NEUROLOGY AND NEUROSURGERY
(2021)
Article
Medicine, General & Internal
Nora I. Ivanova, Mihael E. Tsalta-Mladenov, Darina K. Georgieva, Silva P. Andonova
Summary: Osmotic demyelination syndrome (ODS) is a rare and serious condition caused by rapid correction of hyponatremia, with potential damage in the pontine area or cerebral hemispheres. We report a post-COVID-19 patient diagnosed with ODS, presenting with typical clinical and radiological features of both central pontine myelinolysis and extrapontine myelinolysis. Differential diagnoses include stroke, neuroinfection, neoplasia, and other demyelinating diseases, with ODS showing delayed clinical manifestation after hyponatremia. The association between COVID-19 and ODS is yet to be fully understood, but possible mechanisms include renal dysfunction, diarrhea, or vomiting. ODS should be considered in cases of hyponatremia and neurological deterioration during COVID-19 infection, and early detection and treatment can reduce mortality and disability risk, although complete recovery is not guaranteed.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2023)
Review
Anesthesiology
Francisco Biagio Murta E. Di Flora, Mauricio Vitor Machado Oliveira, Pedro Henrique Torres Menezes, Marina Ayres Delgado
Summary: Based on brain MRI results, liver transplant and cirrhosis were the second and third most frequent causes of CPM, accounting for 13.7% and 12.5% of all diagnoses. In addition to hyponatremia, medical diseases such as cirrhosis, liver transplant, malnutrition, and alcoholism are known risk factors for CPM. Early diagnosis and treatment are crucial for better prognosis. This case report discusses the pathophysiology, risk factors, diagnosis, and treatment of CPM, highlighting the role and challenges of anesthesiologists in managing such patients and preventing the syndrome during major surgery.
SAUDI JOURNAL OF ANAESTHESIA
(2023)
Article
Medicine, General & Internal
ChengYang Lee, ChingChung Ko
Summary: A case initially misdiagnosed as a drug-related extrapyramidal side effect was later diagnosed as osmotic demyelination syndrome with a temporal pattern of change on neuroimaging. Despite discontinuation of suspected causative drugs, the patient's condition did not improve. Further research is needed to support clinical diagnosis and treatment of this rare condition.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2021)
Article
Pharmacology & Pharmacy
Hasan Huseyin Gokpinar, Furkan Erturk Urfali
Summary: Chemodenervation with botulinum neurotoxin type A (BoNTA) is the preferred method for focal spasticity management, but its increasing use raises safety concerns. This paper presents a rare case of acute respiratory distress syndrome developing after BoNTA injection into spastic lower extremity muscles. This is the first reported case of an acute pulmonary complication following BoNTA injection.
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
(2023)
Review
Clinical Neurology
Pyari Bose
Summary: Central pontine myelinolysis and extrapontine myelinolysis, collectively known as osmotic demyelination syndromes, were first described in 1959. Despite the long history, there are still many mysteries surrounding the disorders. Advances in animal models and neuroimaging techniques have improved our understanding of the condition, leading to increased awareness, ante-mortem diagnosis, and decreased mortality rates. This review aims to highlight the clinical spectrum, neuroimaging findings, and recent developments in the field.
ACTA NEUROLOGICA BELGICA
(2021)
Article
Immunology
Stephanie Baker, Jennifer Oster, Antonio Liu
Summary: A 48-year-old female with history of methamphetamine use presented with neurological symptoms including ataxia, gait difficulty, slurred speech and left Cranial Nerve 7 palsy, ultimately diagnosed with central pontine myelinolysis (CPM) based on MRI findings.
BRAIN, BEHAVIOR, & IMMUNITY - HEALTH
(2021)
