Central pontine myelinolysis caused by hypernatremia

Varanda, Sara; Costa, Samuel; Carvalho, Rita; Sousa, Filipa; Carneiro, Gisela

doi:10.1016/j.jns.2016.10.001

Cited by 4 publications

(2 citation statements)

References 9 publications

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“…Kilinç et al described an episode of pontine myelinolysis with normal serum sodium in a 34-year-old male patient on chronic renal dialysis [ 30 ]. Additionally, Varanda et al reported a case of pontine myelinolysis caused by multifactorial hypernatremia in a female patient with liver cirrhosis who was a regular alcohol drinker, which is in agreement with our findings [ 31 ].…”

Section: Discussionsupporting

confidence: 93%

Pontine Myelinolysis Caused by Hypovolemic Hypernatremia

Beraldo

Duarte

Santos³

et al. 2020

Case Reports in Nephrology

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Introduction. Central pontine myelinolysis is characterized by the occurrence of acute demyelinating lesions of cells in the pons secondary to abrupt oscillations of serum osmolarity. Its exact incidence is not well defined, but studies show a prevalence of 0.25 to 0.5% in the general population, 2.5% in the intensive care unit, and up to 10% in patients with risk factors, such as chronic liver disease and hepatic transplantation, alcoholism, malnutrition, diuretic therapy, electrolyte imbalance, hypoglycemia, and hyperglycemia. Case Report. A 70-year-old white female with extranodal diffuse large B-cell non-Hodgkin’s lymphoma (extensive mass on the left anterior chest wall), stage IVA, developed pontine myelinolysis secondary to hypovolemic acute hypernatremia, which occurred due to diarrhea caused by chemotherapy (rituximab, cyclophosphamide, doxorubicin, and vincristine). Discussion. Pontine myelinolysis occurs most often due to the rapid correction of chronic hyponatremia. But here, we describe a case of the disease secondary to the occurrence of hypovolemic acute hypernatremia in a patient with a hematological malignancy under treatment, who was on chronic treatment with thiazide diuretics and who presented with other electrolyte disturbances as risk factors for the development of pontine myelinolysis.

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Section: Discussionsupporting

confidence: 93%

Pontine Myelinolysis Caused by Hypovolemic Hypernatremia

Beraldo

Duarte

Santos³

et al. 2020

Case Reports in Nephrology

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“…In these syndromes, central pontine demyelination involves symmetrical myelin sheath disruption in areas where the white matter becomes exposed to osmotically active substances cleared from edematous grey matter, namely, the crossing pontocerebellar fibers within the pontine nuclei and other grey matter regions containing heavily myelinated fibers, such as the cerebellum and lateral geniculate body2 ) . Clinical recovery from osmotic pontine demyelination can occur with correction of the electrolyte imbalance and underlying systemic disease2,3,4 ) . More than half of patients with osmotic pontine demyelination have favorable outcomes1 ) .…”

Section: Introductionmentioning

confidence: 99%

The effect of white matter integrity on functional outcome in central pontine demyelination

et al. 2019

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Central pontine demyelination is a common osmotic demyelination syndrome. Typically, central pontine demyelination shows high signal intensity with demyelination in the mid-pons. Despite severe imaging findings, patients usually recover. This study investigated the integrity of the corticospinal tract (CST) and corticoreticular pathway (CRP) in patients at 12 months after the onset of central pontine demyelination. [Participants and Methods] This retrospective cross-sectional observational study assessed two patients with central pontine demyelination, who were ultimately able to walk without using an aid or orthosis and to use both hands but with mild residual symptoms. All participants underwent diffusion tensor imaging (DTI) at 12 months after onset. [Results] Both patients had mild ataxia at 12 months after onset. The integrity of the CST was restored in both cases, while the integrity of the CRP recovered partially. [Conclusion] The integrity of the CST and CRP at 12 months after the onset of central pontine demyelination was similar in both cases as well as the recovery status of the hand function and ambulation. These results may be useful in planning therapy for patients with central pontine demyelination.

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Toxic diseases

2022

Large Animal Neurology

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Central pontine myelinolysis caused by hypernatremia

Cited by 4 publications

References 9 publications

Pontine Myelinolysis Caused by Hypovolemic Hypernatremia

Pontine Myelinolysis Caused by Hypovolemic Hypernatremia

The effect of white matter integrity on functional outcome in central pontine demyelination

Toxic diseases

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