What is osmotic Myelinolysis?

What is osmotic Myelinolysis?

Osmotic myelinolysis (OM) is an acute, non-inflammatory demyelinating disease that can develop following rapid correction of hyponatremia from any cause.

What are the symptoms of Pontine Myelinolysis?

Symptoms may include any of the following:

• Confusion, delirium, hallucinations.
• Balance problems, tremor.
• Problem swallowing.
• Reduced alertness, drowsiness or sleepiness, lethargy, poor responses.
• Slurred speech.
• Weakness in the face, arms, or legs, usually affecting both sides of the body.

What causes osmotic demyelination syndrome?

The most common cause of ODS is a quick change in the body’s sodium levels. This most often occurs when someone is being treated for low blood sodium (hyponatremia) and the sodium is replaced too fast. Sometimes, it occurs when a high level of sodium in the body (hypernatremia) is corrected too quickly.

How do you fix overcorrection hyponatremia?

We routinely use desmopressin to prevent the serum sodium from increasing more than it should, and we have frequently administered 5% dextrose in water with desmopressin to re-lower the serum sodium after inadvertent overcorrection of symptomatic hyponatremia; our published and confirmatory unpublished experiences with …

How is Pontine Myelinolysis diagnosis?

Diagnosing central pontine myelinolysis To help diagnose CPM, your doctor will run blood tests to measure your sodium levels. An MRI of your head can show any damage to your brain stem. You may also take a brainstem auditory evoked response (BAER) test.

What happens if you correct Hypernatremia too quickly?

It is important to remember that rapid correction of hypernatremia can lead to cerebral edema because water moves from the serum into the brain cells. The goal is to decrease serum sodium by not more than 12 meq in 24 hours.

Can you recover from osmotic demyelination?

The disorder can resolve completely or result in permanent disability or death. This typical clinical course has been called the osmotic demyelination syndrome (ODS).

What is central pontine myelinolysis (OMS)?

Central pontine myelinolysis, or osmotic demyelination syndrome, is a neurological disease caused by severe damage of the myelin sheath of nerve cells in the brainstem, more precisely in the pons, predominately of iatrogenic etiology. It is characterized by acute paralysis, dysphagia (difficulty swallowing),…

What is osmotic demyelination syndrome (ODS)?

Osmotic demyelination syndrome (ODS) refers to central pontine myelinolysis and extrapontine myelinolysis. These disorders are characterized by insults to regions of the brain with anatomical features predisposing white matter tracts to myelin injury in the setting of osmotic disturbances and their attempted correction.

What causes central pontine myelinolysis in hyponatremia?

Central pontine myelinolysis. It occurs as a consequence of a rapid rise in serum tonicity following treatment in individuals with chronic, severe hyponatremia who have made intracellular adaptations to the prevailing hypotonicity.

What causes extrapontine myelinolysis (EPM)?

In about ten per cent of people with CPM, extrapontine myelinolysis (EPM) is also found. In these cases symptoms of Parkinson’s disease may be generated. The most common cause is overly-rapid correction of low blood sodium levels ( hyponatremia ).