Mielinolisis pontina central pdf

It is predominately iatrogenic treatmentinduced, and is characterized by acute paralysis, dysphagia difficulty swallowing, dysarthria difficulty speaking, and other neurological symptoms. Pontine and extrapontine osmotic myelinolysis after the. Chronic alcoholism or rapid correction of hyponatremia was present in over 75% of cases. Favourable response to the use of intravenous immunoglobulins in central pontine myelinolysis. Revision mielonisis central pontina mielina neurologia. Central pontine myelinolysis radiology reference article. A magnetic resonance imaging showed a central and symmetrical pontine lesion on t1 and t2 weighed images. Central pontine myelinolysis cpm is a neurological condition involving severe damage to the myelin sheath of nerve cells in the pons an area of the brainstem. Desmielinizacion central del cuerpo calloso xpmedico. Enfermedades desmielinizantes del sistema nervioso central. Cartas al director mielinolisis central pontina tras sindrome neuroleptico maligno sr. At the 4th day of admission, the patient was again stuporous and with spastic quadriplegia. Central pontine myelinolysis was first described in 1959 9 and in 1978 reported after liver transplantation 10.

Pdf central pontine myelinolysis is a demyelinating lesion in the basis pontis which in most cases is caused by a rapid correction of hyponatremia. It is characterized by spastic quadriplegia, pseudobulbar palsy and encephalopathy. Central pontine myelinolysis cpm is now more commonly referred to as osmotic demyelination syndrome, which recognizes that the same phenomenon is also seen in other areas of the brain previously known as extrapontine myelinolysis. Convulsiones, estado mental alterado mielinolisis pontina central 82. Central pontine myelinolysis cpm was first described in alcoholic and malnourished patients in 1959 1 and subsequently has been expanded in recent years to include patients with symmetrical extrapontine lesions, notably in the basal ganglia, thalami and midbrain. The clinical features responded dramatically to thiamine supplementation. Antemortem computed tomography ct had been performed in nine, and ante or postmortem magnetic resonance mr imaging in 11. Osmotic demyelination syndrome ods may be precipitated by aggressive correction of a hypo or hyperosmolar states. Serum sodium raised to 120 meql at the next day and the level of consciousness improved. Parkinsonismo secundario a mielinolisis extrapontina. Extrapontine myelinolysis epm is one of the complications occurring secondary to rapid correction of hyponatremia, and is, along with central pontine myelinolysis encompassed by the more recent term osmotic demyelination syndrome.

Mielinolisis central pontina en trasplante hepatico. Described approximately 50 years ago, pontine neuronal demyelination is a pathologic change associated with neurologic and psychiatric problems after liver transplantation. Mielinolisis pontica central posttrasplante hepatico. Central pontine myelinolysis after liver transplantation. All patients presented a severe hepatic encephalopathy. It is the more recent term replacing central pontine myelinolysis, recognizing that extrapontine structures can also be affected, previously known as extrapontine myelinolysis. Pdf mielinolisis pontina central e hiponatremia perioperatoria. Mielinolisis pontina central by pedro molina on prezi. The damage caused is called central pontine myelinolysis cpm epm or cerebral osmotic demylineation. Conventionally this has been perceived to lead to pontine glial cell swelling through. Department of surgery, radiology, anaesthesia and intensive care1, department of medicine2, tropical medicine research institute3.

Extrapontine myelinolysis radiology reference article. Abstract there is a controversy wheter central pontine myelinolysis can complicate either hyponatremia or its rapid correction. Lock in syndrome, low sodium, central pontine myelinolysis. Mielinolisis central pontina tras sindrome neuroleptico. Critically ill patients frequently develop neurologic symptoms, which frequently become a clinical challenge. There is a controversy wheter central pontine myelinolysis can complicate either hyponatremia or its rapid correction. Osmotic demyelination syndrome refers to acute demyelination seen in the setting of osmotic changes, typically with the rapid correction of hyponatremia. It is observed in patients with severe hyponatremia, particularly when the hyponatremia is corrected too rapidly.

Recently, with better understanding, these conditions were more appropriately recognized as part of the osmotic demyelination. As such the condition is described in the osmotic demyelination syndrome article. It is observed in patients with severe hyponatremia, particularly when the hyponatremia is. Central pontine myelinolysis or osmotic demyelination syndrome is a disorder consisting of noninflammatory demyelination, involving the pons. A central nervous system disorder caused by demyelination within the central basis pontis of the brain. In the absence of alterations in osmolality, they developed, between the second to seventh day after transplantation, a central quadriplegia, hyperreflexia and babinski sign, with preservation of sensorium. Mielinolisis central pontina en trasplante hepatico core. Sequential observation of movements disorders and brain images in the case of central pontine myelinolisis and extrapontine myelinolsis. One of the well recognized stimuli for central pontine myelinosis cpm is the rapid correction of chronic hyponatraemia. By definition, it is a noninflammatory, frequently symmetrical central pontine demyelination.