Central pontine myelinolysis

Central pontine myelinolysis is a neurologic disease caused by severe damage of the myelin sheathof nerve cellsin the brainstem, more precisely in the area termed the pons. The most common cause is the rapid correction of low blood sodium levels (hyponatremia). Some scholars postulate that the real cause might be the lack of a substance that is essential for brain activity and is lacking due to malnutrition. The fact that this condition is most frequently observed in patients with general ill health (alcoholism, cachexiaetc.) is in accordance with this assumption. Imaging by MRIdemonstrates an area of high signal return on T2 weighted images. Frequently observed symptoms in this disorder are weakness, double visionand loss of consciousness.

References

• Adams RA, Victor M, Mancall EL. Central pontine myelinolysis: a hitherto undescribed disease occurring in alcoholics and malnourished patients. Arch Neurol Psychiatry. 1959;81:154?72. PMID 13616772

• Gocht A , Colmant HJ. Central pontine and extrapontine myelinolysis: a report of 58 cases. Clin Neuropath. 1987;6:262?70. PMID 3322623

• Kleinschmidt-DeMasters BK, Norenberg MD. Rapid correction of hyponatremia causes demyelination: relation to central pontine myelinolysis. Science. 1981;211(4486):1068-70. PMID 7466381

• Laureno R. Experimental pontine and extrapontine myelinolysis. Trans Am Neurol Assoc. 1980;105:354-8. PMID 7348981

• Menger H , Jorg J. Outcome of central pontine and extrapontine myelinolysis (n=44). J Neurol. 1999;246:700?5. PMID 10460448

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