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
Pharmacology & Pharmacy
Zhihong Zhao, Lu Han, Zilong Zhu
Summary: EPM is a rare demyelinating disease of the central nervous system that can occur with or without central pontine myelinolysis (CPM). This case report describes a patient with depression who developed EPM and dysphagia after prolonged use of the antianxiety-antidepressant drug flupentixol and melitracen. Treatment with promethazine and discontinuation of flupentixol and melitracen resulted in significant improvement of symptoms.
FRONTIERS IN PHARMACOLOGY
(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
Wenfeng Ye, Wenjie Huang, Linlin Chen, Changfang Yao, Shiying Sheng, Zhengyu Liu, Chunyan Xue, Wei Xing
Summary: Pituitary tumor apoplexy is a rare but life-threatening condition that requires urgent diagnosis and treatment. Managing undiagnosed cases of pituitary tumor during pregnancy can be challenging. Regular MRI examinations are crucial for monitoring the treatment outcomes and tumor regression.
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
Endocrinology & Metabolism
Maria Tomkins, Sarah Lawless, Julie Martin-Grace, Mark Sherlock, Chris J. Thompson
Summary: This article primarily introduces the diagnosis and treatment of central diabetes insipidus, as well as the related physiological disturbances. Recent developments in diagnostic techniques have improved the accuracy and acceptability of the diagnostic approach. The article also discusses the management of fluid intake and pharmacological replacement of AVP, as well as the management of related clinical syndromes.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2022)
Article
Biotechnology & Applied Microbiology
Xinhuang Lv, Qian Hong, Xiuxiu Lin, Weian Chen, Yuan Tian
Summary: Osmotic demyelination syndrome is a complex disease with various etiologies, showing diverse symptoms involving different brain systems. Early identification and removal/correction of the causative conditions are crucial in preventing and managing this disease.
BIOMED RESEARCH INTERNATIONAL
(2021)
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
Medicine, General & Internal
Muhammad Abd Ur Rehman, Abdulrahman Fadhl Abdulrahman, Aariz Zainab, Yahya Paksoy, Nadir Kharma
Summary: Symptomatic hyponatremia in COVID-19 co-infection patients should be treated with extra caution, as it may pose another risk factor for the development of extrapontine myelinolysis until more evidence is available.
CLINICAL CASE REPORTS
(2021)
Article
Clinical Neurology
Esra Sarigecili, Sevgin Taner, Habibe Koc Ucar, Burcak Cakir Pekoz
Summary: Osmotic demyelination syndrome is a rare condition in childhood, usually caused by rapidly correcting hyponatremia, and even more rare in patients with chronic renal failure. This article presents a rare case occurring in a pediatric patient.
CHILDS NERVOUS SYSTEM
(2021)
Letter
Pharmacology & Pharmacy
Umang Arora, Ayush Goel, Animesh Ray, Naval K. Vikram
Summary: ODS and NMS are two syndromes that lead to severe neurological sequalae, with literature suggesting a relationship between the two. This case report highlights the difficulty in differentiating between ODS and NMS and their relationship.
DRUG DISCOVERIES AND THERAPEUTICS
(2022)
Article
Medicine, General & Internal
Cleofina Furtado, Sanjeev Nayak, Changrez Jadun, Sachin Srivastava, Zafar Hashim
Summary: Conventional MRI and CT are used for diagnosing CPM, but their efficacy in early diagnosis is limited. This article reviews the relationship between radiological changes, clinical symptoms, and serum sodium levels, and introduces pioneering advances in radiomic analysis for early diagnosis.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2022)
Article
Medicine, Legal
Matthew Rumschlag, Joseph A. Prahlow, Rudolph J. Castellani, Amanda O. Fisher-Hubbard
Summary: This article discusses the importance of appropriate microscopic and immunohistochemical analysis of suspected cases of central pontine myelinolysis.
AMERICAN JOURNAL OF FORENSIC MEDICINE AND PATHOLOGY
(2022)
Article
Endocrinology & Metabolism
Asuman Orhan Varoglu, Asude Aksoy, Aysenur Avarisli, Didem Darici, Emre Akbas
Summary: This article reports a case of extrapontine myelinolysis (EPM) that initially presented with severe clinical symptoms, but parkinsonism symptoms were completely improved after treatment. Prompt diagnosis and treatment can save a patient's life.
NEUROENDOCRINOLOGY LETTERS
(2023)
Review
Medicine, General & Internal
Abia Joseph, Tass Sayeed, Dev K. Patel, Sanathan Aiyadurai, Zainab Shahbaz, Sambasiva Rao Mettela, Tulika Garg, Rishika Gadde, Datiobong Udoeyop, Aadil Khan
Summary: Aggressive treatment of hyper or hypoosmolar conditions can lead to osmotic demyelination syndrome. We present a case of carbamazepine-induced syndrome of inappropriate antidiuretic hormone secretion in a 53-year-old male with bipolar affective disorder. The patient showed improvement in mental state after correcting hyponatremia with 3% normal saline. Neuroimaging revealed diffuse cerebral atrophy, periventricular ischemia demyelination alterations, and an enhanced section in the brainstem, indicative of osmotic demyelination alterations. Supportive therapy and ventilatory support were initiated for the patient, who was sent home with follow-up instructions despite a grim prognosis.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2023)