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Extrapontine Myelinolysis

Presentation

Treatment response in osmotic demyelination syndrome presenting as severe parkinsonism, ptosis and gaze palsy. BMJ Case Rep. 2018. pmid:30344146 PubMed Shah P, Jacobs C, Ataya A. More haste, less speed: hyponatraemia and osmotic demyelination. [nevrologi.legehandboka.no]

Prior to its onset, patients may present with the neurological signs and symptoms of hyponatraemic encephalopathy such as nausea and vomiting, confusion, headache and seizures. [en.wikipedia.org]

Gastrointestinal

  • Dysphagia

    It is predominately iatrogenic (treatment-induced), and is characterized by acute paralysis, dysphagia (difficulty swallowing), dysarthria (difficulty speaking), and other neurological symptoms. [en.wikipedia.org]

Treatment

Bibl D, Lampl C, Gabriel C, et al (1999) Treatment of central pontine myelinolysis with therapeutic plasmapheresis. [link.springer.com]

It is predominately iatrogenic (treatment-induced), and is characterized by acute paralysis, dysphagia (difficulty swallowing), dysarthria (difficulty speaking), and other neurological symptoms. [en.wikipedia.org]

Treatment response in osmotic demyelination syndrome presenting as severe parkinsonism, ptosis and gaze palsy. BMJ Case Rep. 2018. pmid:30344146 PubMed Shah P, Jacobs C, Ataya A. More haste, less speed: hyponatraemia and osmotic demyelination. [nevrologi.legehandboka.no]

Prognosis

Réanimation Soin intensif Unité soin intensif Myélinolyse centropontine Syndrome de démyélinisation osmotique Pathologie de l'encéphale Pathologie du système nerveux central Pathologie du système nerveux Trouble métabolique Keyword (en) Clinical management Prognosis [pascal-francis.inist.fr]

[edit] Though traditionally the prognosis is considered poor, a good functional recovery is possible. [en.wikipedia.org]

J Neural Transm 106:949–953 Article PubMed CAS Google Scholar Odier C, Nguyen DK, Panisset M (2010) Central pontine and extrapontine myelinolysis: from epileptic and other manifestations to cognitive prognosis. [link.springer.com]

Epidemiology

Clin Nephrol 67:345–351 PubMed CAS Google Scholar Fraser CL, Arieff AI (1997) Epidemiology, pathophysiology, and management of hyponatremic encephalopathy. [link.springer.com]

Pathophysiology

Clin Nephrol 67:345–351 PubMed CAS Google Scholar Fraser CL, Arieff AI (1997) Epidemiology, pathophysiology, and management of hyponatremic encephalopathy. [link.springer.com]

Alcoholism Hypokalemia People with serum sodium <105 mEq/L Severe burns[18][19] Malnutrition Anorexia nervosa[20][21][22] Severe electrolyte disorders HIV/AIDS hyperemesis gravidarum[23][24] Hyponatremia due to peritoneal dialysis Wernicke encephalopathy[25] Pathophysiology [en.wikipedia.org]

Prevention

Neurology 57:1931–1932 Article PubMed CAS Google Scholar Perianayagam A, Sterns RH, Silver SM, et al (2008) DDAVP is effective in preventing and reversing inadvertent overcorrection of hyponatremia. [link.springer.com]

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