Central pontine myelinolysis medical therapy: Difference between revisions
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{{Central pontine myelinolysis}} | {{Central pontine myelinolysis}} | ||
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==Medical Therapy== | ==Medical Therapy== | ||
To avoid myelinolysis, the correction of hyponatremia should not exceed 1 mEq/L per hour. <ref>Kleinschmidt-DeMasters BK, Norenberg MD. Rapid correction of hyponatremia causes demyelination: relation to central pontine myelinolysis. ''Science.'' 1981;211(4486):1068-70. PMID 7466381</ref><ref>Laureno R. Experimental pontine and extrapontine myelinolysis. ''Trans Am Neurol Assoc.'' 1980;105:354-8. PMID 7348981</ref> There is no specific treatment and the syndrome is associated with high mortality and morbidity. This being a potentially avoidable disaster, following recommendations may be adhered to while maintaining sodium levels: | To avoid myelinolysis, the correction of hyponatremia should not exceed 1 mEq/L per hour. <ref>Kleinschmidt-DeMasters BK, Norenberg MD. Rapid correction of hyponatremia causes demyelination: relation to central pontine myelinolysis. ''Science.'' 1981;211(4486):1068-70. PMID 7466381</ref><ref>Laureno R. Experimental pontine and extrapontine myelinolysis. ''Trans Am Neurol Assoc.'' 1980;105:354-8. PMID 7348981</ref> There is no specific treatment and the syndrome is associated with high mortality and morbidity. This being a potentially avoidable disaster, following recommendations may be adhered to while maintaining sodium levels: | ||
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Revision as of 20:52, 3 December 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Medical Therapy
To avoid myelinolysis, the correction of hyponatremia should not exceed 1 mEq/L per hour. [1][2] There is no specific treatment and the syndrome is associated with high mortality and morbidity. This being a potentially avoidable disaster, following recommendations may be adhered to while maintaining sodium levels:
Hyponatremia
The rate of correction of hyponatremia should be 0.5-1.0meq/L/hr, with not more than a 12 meq/l correction in 24 hrs. If the patient has ongoing seizures (or [Na+]<115 meq/li), correction can be attempted at up to 2 meq/L/hr, but only while seizure activity lasts and the [Na+] exceeds 125-130 meq/Li.
Hypernatremia
The rate of correction of hypernatremia should be at 0.5meq/L/hr and should not exceed 12 meq/Li/24hrs.
References
- ↑ Kleinschmidt-DeMasters BK, Norenberg MD. Rapid correction of hyponatremia causes demyelination: relation to central pontine myelinolysis. Science. 1981;211(4486):1068-70. PMID 7466381
- ↑ Laureno R. Experimental pontine and extrapontine myelinolysis. Trans Am Neurol Assoc. 1980;105:354-8. PMID 7348981