Immunoglobulins Are Effective in Pontine Myelinolysis

Finsterer, Josef; Engelmayer, Elfriede; Trnka, Elisabeth; Stiskal, Michael

doi:10.1097/00002826-200003000-00009

Cited by 41 publications

(29 citation statements)

References 10 publications

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“…In a clinical setting a daily dose of 375 mg of intravenous methylprednisolone given to patients diagnosed as having CPM proved to be effective [68, 69, 70]. …”

Section: Therapy and Prognosismentioning

confidence: 99%

Central Pontine Myelinolysis

Lampl

Yazdi²

2002

Eur Neurol

223

143

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Central pontine myelinolysis (CPM) is a demyelinating disease of the pons often associated with demyelination of other areas of the central nervous system (CNS). The term ‘osmotic demyelinization syndrome’ is used for pontine and extrapontine myelinolysis. In this paper, we are concerned with CPM although the extrapontine one is based on the same pathogenesis. Both share the diagnostic methods, and their prevention and therapy are the same. The etiology and pathogenesis of this disorder are unclear and will be discussed. However, almost all cases of CPM are related to severe diseases. Chronic alcoholism is still the most common underlying condition of CPM patients. In the literature, 174 cases of CPM have been reported in alcoholics since 1986, which is equivalent to an incidence of 39.4%. Likewise, 95 cases of CPM following the correction of hyponatremia have been documented since 1986 (21.5%). The role of hyponatremia and its correction will be outlined in the discussion of the pathogenesis of CPM. The third largest group of CPM cases are liver transplant patients (17.4%), with the development of CPM being attributed to the immunosuppressive agent cyclosporine in particular. Depending on the involvement of other CNS structures, the clinical picture can vary considerably. The large-scale introduction of magnetic resonance imaging has increasingly facilitated the antemortem diagnosis of CPM, although the radiological findings lag behind and do not necessarily correlate with the clinical picture. As yet, there is no specific therapy of choice. A number of therapeutic approaches have been tested and although they have not been compared with regard to their rate of success, they have all led to a substantial improvement in the prognosis of CPM.

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“…In a clinical setting a daily dose of 375 mg of intravenous methylprednisolone given to patients diagnosed as having CPM proved to be effective [68, 69, 70]. …”

Section: Therapy and Prognosismentioning

confidence: 99%

Central Pontine Myelinolysis

Lampl

Yazdi²

2002

Eur Neurol

223

143

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“…4 5 Postulated mechanisms include reduction of myelinotoxic agents, development of antimyelin antibodies, and promotion of remyelination. 4 We report a case of CPM associated with chronic alcoholism and hyponatremia, with significant clinical improvement and resolution of MRI changes after treatment with IVIG.…”

Section: Introductionmentioning

confidence: 90%

Improvement in Central Pontine Myelinosis with IV immunoglobulin

Ramos¹

2012

JPRLS

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“…Ma no ma, kad gliu kokor ti koi dai sta bi li zuo ja he ma to en ce fa li ná bar je rà, slo pi na mie lo tok si niø ci to ki nø pa te ki mà ir ska ti na re mie li ni za ci jà [47]. Ta èiau imu no sup re suo tiems pa cien tams po ke pe nø transp lan ta ci jos, ypaè tiems, ku rie var to jo cik los po ri nà, ðis gy dy mo me to das ne tin ka [48].…”

Section: Gydymo Galimybësunclassified

“…Ki tas gy dy mo bû das -IVIG 0,4 g/kg per die nà 5 die nø kur sas. Ðio gy dymo po vei kis yra su si jaes su mie lo tok si niø me dþia gø ir an timie li ni niø an ti kû nø su si da ry mo su ma þë ji mu ir re mie li niza ci jos pa lai ky mu [48]. K. At cha ne e y a sa kul su ben dra darbiais ap þvel gë dau gu mà pa skelb tø CTM at ve jø, kai gy dymui bu vo skir ta IVIG ir (ar) GA [50].…”

Section: Gydymo Galimybësunclassified

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

Rutkauskaitė

Klimašauskienė

2018

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Vilniaus universitetas, Medicinos fakultetas, Klinikinës medicinos institutas, Neurologijos ir Neurochirurgijos klinika ÁVADASOs mo si në mie li no li zë (OM) yra re tas ir ûmus de mie li nizuo jan tis su sir gi mas. 1959 m. R. D. Ad ams su ko le go mis [1] pir mie ji ap ra ðë cen tri nae til to mie li no li zae (CTM), ku rià diag no za vo al ko ho liu pik tnau dþiau jan tiems ir pras tai be simai ti nan tiems as me nims. Vë liau nu sta ty ta, kad iden tið ki pa to lo gi niai po ky èiai ga li pa si reikð ti taip pat uþ til to ri bø, jie pa va din ti eks tra pon ti ni ne mie li no li ze (EPM). Vyk dant moks li nius ty ri mus, ið aið kin tas ry ðys tarp OM ir grei tos nat rio ko rek ci jos pa cien tams, ser gan tiems hi po nat re mi ja. EPIDEMIOLOGIJATiks lus OM pa pli ti mas në ra þi no mas. Pir mie ji duo me nys apie OM gau ti au to psi jø me tu. M. Vic tor ir R. Lau re no apra ðy to je 3 548 su au gu siø jø au to psi jø ana li zë je OM bû din gi pa þei di mai ras ti 0,25 % at ve jø [2]. Ki ta me moks li nia me dar be bu vo ið ana li zuo ta 3 000 mi ru siø jø sme ge nø, 0,005 % jø nu sta ty ta asimp to më CTM [3]. Au to psi jø ana li zë je didþiau sias OM pa pli ti mas, nu sta ty tas 30-50-ai siais gy ve nimo me tais, dau giau bû din gas vy rams [4], ta èiau pa to lo giniai po ky èiai pa ste bë ti ir vai kams [5,6]. A. Gocht ir ko le gø [7] au to psi jø stu di jo je ið nag ri në ti 58 OM kli ni ki niai at ve - San trau ka. Cen tri në til to mie li no li zë api bû di na ma kaip os mo si nës mie li no li zës sin dro mas, daþ niau siai ið si vys tan tis kaip kom pli ka ci ja po grei tos hi po nat re mi jos ko rek ci jos. Til to mieli no li zë skirs to ma á cen tri nae til to mie li no li zae ir eks tra pon ti ni nae mie li no li zae. Hi po nat re mi ja daþ nai nu sta to ma pa cien tams, ku rie pik tnau dþiau ja al ko ho liu, pras tai mai ti na si, var to jant tam tik rus vais tus, taip pat ser gant ke pe nø li go mis, esant pa ki tu siai an ti diu re zi nio hor mo no sin te zei, ant inks èiø ne pa kan ka mu mui. Yra ke le tas pa to fi zio lo gi niø me cha niz mø, pa aið kinan èiø os mo si nës mie li no li zës ið si vys ty mà. Bû din ga dvi fa zë li gos ei ga. Pir mie ji simp to mai yra en ce fa lo pa ti ja ir (ar) trau ku liø prie puo liai, pa si reið kae dël hi po nat re mi jos, vë liau ste bi mas at si sta ty mas nor mo nat re mi jos me tu ir po ke liø die nø -pa blo gë ji mas, ga lin tis pa si reikð ti þi -di ni ne neu ro lo gi ne simp to ma ti ka, psi chi kos ir el ge sio su tri ki mais. Anks èiau siai bû din gus pa ki ti mus sme ge ny se ga li ma pa ste bë ti mag ne ti nio re zo nan so to mog ra fi jos DWI re þi mu. Patvir tin tø os mo si nës mie li no li zës gy dy mo re ko men da ci jø në ra, ta èiau li te ra tû ro je ap ra ðo mi sëk min gi at ve jai, pa cien tus gy dant ti rot ro pi nà ið ski rian èiu hor mo nu, gy do mo sio mis afe re zë -mis, gliu ko kor ti koi dais, in tra ve ni niu imu nog lo bu li nu. Os mo si nës mie li no li zës ga li ma ið -veng ti, hi po nat re mi jos me tu nat rio kon cen tra ci j...

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Immunoglobulins Are Effective in Pontine Myelinolysis

Cited by 41 publications

References 10 publications

Central Pontine Myelinolysis

Central Pontine Myelinolysis

Improvement in Central Pontine Myelinosis with IV immunoglobulin

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

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