Central Pontine and Extrapontine Myelinolysis

Abstract

Various case reports of ODS have been published from time to time with few case series out of which the largest being studied is the one in 58 patients. 5 [ 1 9 _ T D $ D I F F ] Though [ 2 0 _ T D $ D I F F ] the exact incidence of ODS is a p o l l o m e d i c i n e 1 3 ( 2 0 1 6 ) 2 2 0 -2 2 3 a r t i c l e i n f o Article history:

Osmosinės mielinolizės sindromas (centrinė tilto ir ekstrapontininė mielinolizė): literatūros apžvalga ir atvejo pristatymas

“…Van duo ið þe mo os mo lia rið ku mo tarp làs te li nës terpës pa ten ka per ak va po ri no ka na lus á aukð tes nio os mo liarið ku mo in tra làs te li nae ter pae [21], gli jos làs te lës pa brinks ta ir vys to si sme ge nø ede ma [9].…”

“…Ne pa vy kus at kur ti làs -te lës plaz mos to nið ku mo, ið si vys to os mo si nis stre sas, dël ku rio làs te lës su si trau kia, ið yra glau dþio sios jung tys ir paþei dþia mas he ma to en ce fa li nis bar je ras [21]. Vë liau mie lino dan ga las ati trûks ta nuo ak so nø, pa þei dþia mi oli go dendro ci tai ir pa lei dþia mas apop to zës me cha niz mas [20].…”

Locked‐in syndrome after central pontine myelinolysis, an outstanding outcome of two patients

“…8 This phenomenon, named osmotic demyelination syndrome (ODS), can be centered within the pons (CPM) and/or affect other regions (Extrapontine myelinolysis, EPM). 9 Based on isolated cases or case-series, [1][2][3][9][10][11][12][13][14][15][16] its epidemiology remains poorly documented but the incidence of which was estimated to be 2.5% among overall stays in a recent study performed in India over 5 years in an intensive care unit. 16 Intrinsic factors favoring the appearance of myelinolysis have been identified 2 ; these include chronic systemic disease (cancer, liver disease, 10 liver transplantation, 17 diabetes, sepsis, severe burns, 18 electrolyte disorders, etc.…”

“… 8 This phenomenon, named osmotic demyelination syndrome (ODS), can be centered within the pons (CPM) and/or affect other regions (Extrapontine myelinolysis, EPM). 9 Based on isolated cases or case‐series, 1 , 2 , 3 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 its epidemiology remains poorly documented but the incidence of which was estimated to be 2.5% among overall stays in a recent study performed in India over 5 years in an intensive care unit. 16 …”

“…followed by a spontaneous gradual regression, and then, a second phase of neurological degradation is reported to occur in the following days with the appearance of dysarthria, obnubilation, quadriplegia, ataxia, and even LIS or death. 2 , 8 , 9 It is thus a disease with a potentially very poor prognosis although improvements in neuroimaging and treatments have led to improve the morbi‐mortality of CPM 8 , 11 , 23 ; this is illustrated by two case series studies that found that more than half of the patients with ODS regain independent function. 12 , 24 However, to the best of our knowledge information related to the course of the most severe cases, in particular those presenting initial LIS, is limited to only the diagnosis and hospital discharge.…”