Central pontine myelinolysis overview
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Differentiating Central pontine myelinolysis from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Central pontine myelinolysis is a neurologic disease caused by severe damage of the myelin sheath of 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.
Pathophysiology
Rapid correction of hypernatremia causes water to move into cells, leading to multiple cerebral hemorrhages, equally catastrophic as osmotic demyelination.
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.