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| {{Central pontine myelinolysis}} | | {{Central pontine myelinolysis}} |
| {{CMG}} | | {{CMG}}; {{AE}}{{MMJ}} |
| ==Overview== | | ==Overview== |
| '''Central pontine myelinolysis''' is a neurologic disease caused by severe damage of the [[myelin sheath]] of [[neuron|nerve cells]] in the [[brainstem]], more precisely in the area termed the [[pons]]. It is a complication of treatment of patients with profound, life threatening [[hyponatraemia]]. It occurs as a consequence of a rapid rise in serum tonicity following treatment in individuals with chronic severe hyponatraemia who have made intracellular adaptations to the prevailing hypotonicity. It can also occur as a complication of correcting [[hypernatremia]] too rapidly.
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| | ==Historical Perspective== |
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| | ==Classification== |
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| ==Pathophysiology== | | ==Pathophysiology== |
| Rapid correction of [[hypernatremia]] causes water to move into cells, leading to multiple cerebral hemorrhages, equally catastrophic as osmotic demyelination.
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| ==Causes== | | ==Causes== |
| The most common cause is the rapid correction of low blood sodium levels ([[hyponatremia]]). Over rapid correction of high levels of salt in the blood ([[hypernatremia]]) can also cause the condition.
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| | ==Differentiating central pontine myelinolysis from Other Diseases== |
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| | ==Epidemiology and Demographics== |
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| ==Risk Factors== | | ==Risk Factors== |
| It has been postulated that one underlying cause may be the lack of a substance that is essential for brain activity and is lacking due to [[malnutrition]]. The fact that this condition is most frequently observed in patients with general ill health ([[alcoholism]], [[cachexia]] etc.) is in accordance with this hypothesis. <ref>Adams RA, Victor M, Mancall EL. Central pontine myelinolysis: a hitherto undescribed disease occurring in alcoholics and malnourished patients. ''Arch Neurol Psychiatry.'' 1959;81:154–72. PMID 13616772</ref>
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| | ==Screening== |
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| | ==Natural History, Complications, and Prognosis== |
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| ==Diagnosis== | | ==Diagnosis== |
| | ===Diagnostic Study of Choice=== |
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| | ===History and Symptoms=== |
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| | ===Physical Examination=== |
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| | ===Laboratory Findings=== |
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| | ===Electrocardiogram=== |
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| | ===X-ray=== |
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| | ===Echocardiography and Ultrasound=== |
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| | ===CT scan=== |
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| ===MRI=== | | ===MRI=== |
| Imaging by [[Magnetic resonance imaging|MRI]] demonstrates an area of high signal return on T2 weighted images. | | |
| | ===Other Imaging Findings=== |
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| | ===Other Diagnostic Studies=== |
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| ==Treatment== | | ==Treatment== |
| ===Prevention=== | | ===Medical Therapy=== |
| Gradual, controlled treatment of low sodium levels may reduce the risk of nerve damage in the pons. Being aware of how some medications can change sodium levels can prevent these levels from changing too quickly.
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| | === Interventions === |
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| | ===Surgery=== |
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| | ===Primary Prevention=== |
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| | ===Secondary Prevention=== |
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| ==References== | | ==References== |
| {{Reflist|2}} | | {{reflist|2}} |
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| [[Category:Disease]]
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| [[Category:Neurology]]
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| [[Category:Intensive care medicine]]
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| [[Category:Nephrology]]
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| [[Category:Emergency medicine]]
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| {{WikiDoc Help Menu}} | | {{WikiDoc Help Menu}} |
| {{WikiDoc Sources}} | | {{WikiDoc Sources}} |
| | [[Category: (name of the system)]] |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating central pontine myelinolysis from Other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Interventions
Surgery
Primary Prevention
Secondary Prevention
References
Template:WikiDoc Sources