Current Concepts in Pontine Myelinolysis: Review of Literature

Dagur, Gautam; Khan, Sardar

doi:10.21767/2172-0479.100038

Cited by 5 publications

(10 citation statements)

References 71 publications

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“…Today, it is known as ODS, and it is subdivided into CPM (the most frequent form) and EPM. [2] Although ODS is a rare condition, its true incidence is unknown and often underdiagnosed [1]. e main risk factor for ODS is rapid correction of chronic hyponatremia, particularly when it is lower than 120 meq/L [3].…”

Section: Discussionmentioning

confidence: 99%

“…When hyponatremia is corrected too quickly, cells cannot readapt fast enough to the higher osmolality and are at risk of lysis. Oligodendrocytes are the most affected cells [1]. Other risk factors that may contribute to osmotic demyelination are as follows: malnutrition, chronic alcoholism, primary adrenal insufficiency, prolonged use of diuretics, hypokalemia, hyperglycemia, fluid resuscitation, hemodialysis, and liver transplant [2].…”

Section: Discussionmentioning

confidence: 99%

“…Osmotic demyelination syndrome (ODS) is a rare condition [1] characterized by loss of myelin in various parts of the central nervous system. It is subdivided into central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM), depending on what level the demyelination occurs [2].…”

Section: Introductionmentioning

confidence: 99%

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Osmotic Demyelination Syndrome in a Patient with Hypokalemia but No Hyponatremia

Ormonde

Cabral

Serpa

2020

Case Reports in Nephrology

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Osmotic demyelination syndrome (ODS) is characterized by loss of myelin in various parts of the central nervous system. It is mainly caused by a rapid correction of hyponatremia, although other factors that may cause rapid rise in serum osmolality can also be associated with its development. Its prognosis is poor and the recovery rate is unknown. The authors report a rare case of a patient with multiple risk factors for ODS, without hyponatremia, who developed ODS and surprisingly recovered. This case report highlights the importance of recognizing risk factors for the development of ODS, even if the main one is not present.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Osmotic Demyelination Syndrome in a Patient with Hypokalemia but No Hyponatremia

Ormonde

Cabral

Serpa

2020

Case Reports in Nephrology

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“…It is also known as osmotic demyelination syndrome (ODS), which includes CPM and extrapontine myelinolysis (EPM) [ 2 ]. The clinical presentation of ODS includes various neurologic symptoms including consciousness disturbance, flaccid quadriplegia, dysarthria, and dysphagia [ 2 ]. This neurologic disorder has often been associated with overly corrected hyponatremia [ 3 ]; however, other factors such as alcoholism [ 4 ], malnutrition [ 5 ], and electrolyte disturbance [ 4 , 6 ] have also been described.…”

Section: Introductionmentioning

confidence: 99%

“…The pathogenesis of ODS is poorly understood [ 2 ]. However, a possible hypothesis is that the glial cells are swollen during chronic hyponatremia, and treatment with hypertonic saline creates a hypertonic state and causes shrinkage of cells.…”

Section: Introductionmentioning

confidence: 99%

Excessive Sodium Bicarbonate Infusion May Result in Osmotic Demyelination Syndrome During Treatment of Diabetic Ketoacidosis: A Case Report

Hsieh

Chiu

et al. 2019

Diabetes Ther

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Introduction We present a case wherein diabetic ketoacidosis (DKA) was treated with a large amount of sodium bicarbonate and potassium chloride, resulting in the development of osmotic demyelination syndrome (ODS). Case presentation Our patient was a 29-year-old male with a history of post-surgical repair for ventricular septal defect. Upon arrival, the patient’s Glasgow Coma Scale (GCS) score was E2M4V3. Laboratory examinations revealed leukocytosis, severe metabolic acidosis, hypokalemia, and hyperglycemia. His consciousness status and hemodynamics improved after resuscitation (GCS: E3M6Ve). However, they declined at the 40th hour of admission and dropped to GCS E2M2Ve. Magnetic resonance imaging revealed multifocal abnormal signal intensity changes in the whole brain stem. The diagnosis of type 1 diabetes mellitus was made during the hospitalization period. The patient exhibited improved consciousness status after 17-day medical care at the ICU. Conclusions We recommend that in the case of DKA, the correction of hypokalemia should be prioritized during treatment. Sodium bicarbonate infusion should be reserved for pH < 6.9. In addition, close monitoring of the serum sodium level and prompt actions to lower it if it exceeds the threshold may be necessary.

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Speech and swallowing difficulties and rehabilitation in osmotic demyelination syndrome: A single case report

Monish¹,

Sreedevi²

2022

IJOAS

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: Aim of the work was to highlight the speech and swallowing difficulties that are associated with osmotic demyelination syndrome and also the importance of speech and language therapy in patients with osmotic demyelination syndrome. In this case report, a 68 years old female who developed osmotic demyelination syndrome as a result of hyponatremia correction has been described. The patient developed motor, speech and swallowing difficulties after 10 day of hyponatremia correction. For assessing speech and language skills, Bedside Screening Test for Persons with Aphasia was used. Gugging Swallowing Screen was used for assessing the swallowing skills.: The assessment results indicated that the patient’s auditory comprehension skills were preserved and other verbal skills were affected as the patient had mutism. Also the patient had slight dysphagia with lower risk of aspiration. With speech-language intervention, improvement was observed in swallowing and verbal communication skills. ODS is a rare clinical condition. In order to have a better perspective about speech, language and swallowing skills in individuals with ODS, replication of such studies are essential.

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Current Concepts in Pontine Myelinolysis: Review of Literature

Cited by 5 publications

References 71 publications

Osmotic Demyelination Syndrome in a Patient with Hypokalemia but No Hyponatremia

Osmotic Demyelination Syndrome in a Patient with Hypokalemia but No Hyponatremia

Excessive Sodium Bicarbonate Infusion May Result in Osmotic Demyelination Syndrome During Treatment of Diabetic Ketoacidosis: A Case Report

Speech and swallowing difficulties and rehabilitation in osmotic demyelination syndrome: A single case report

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