Central pontine myelinolysis history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

Overview

Patients with central pontine myelinolysis may have a positive history of: Malnutrition, alcohol use disorder, chronic liver disease, hyperemesis gravidarum, hypophosphatemia secondary to refeeding syndrome and prolonged ischemia. These patients with central pontine myelinolysis most commonly have a history of rapid sodium correction, greater than 0.5-1.0 mEq/L per hour. The most susceptible patients are those with: Chronic hyponatremia (>48 hours), severe hyponatremia (Na <120 mEq/L) and both chronic hyponatremia and severe hyponatremia. Common symptoms of central pontine myelinolysis include: Spastic quadriparesis, dysarthria, pseudobulbar palsy and altered mental status. In some patients, parkinsonian features, behavioral manifestations, and neuropsychological symptoms can also be present: Personality changes, labile affect, disinhibition, poor judgment, paranoid delusions, emotional lability, delirium, hallucinations and catatonia.

History and Symptoms

History

Patients with central pontine myelinolysis may have a positive history of:[1][2][3]

These patients with central pontine myelinolysis most commonly have a history of rapid sodium correction, greater than 0.5-1.0 mEq/L per hour.

The most susceptible patients are those with:[1]

Common Symptoms

Common symptoms of central pontine myelinolysis include:[1][2][3][4]

In some patients, parkinsonian features, behavioral manifestations, and neuropsychological symptoms can also be present:[4]

References

  1. 1.0 1.1 1.2 "StatPearls". 2019. PMID 31869161.
  2. 2.0 2.1 Seliger S, Kestenbaum B (2018). "Commentary on Treatment of Severe Hyponatremia". Clin J Am Soc Nephrol. 13 (4): 650–651. doi:10.2215/CJN.13381217. PMC 5969468. PMID 29295827.
  3. 3.0 3.1 Yu J, Zheng SS, Liang TB, Shen Y, Wang WL, Ke QH (2004). "Possible causes of central pontine myelinolysis after liver transplantation". World J Gastroenterol. 10 (17): 2540–3. doi:10.3748/wjg.v10.i17.2540. PMC 4572157. PMID 15300900.
  4. 4.0 4.1 Gopal M, Parasram M, Patel H, Ilorah C, Nersesyan H (2017). "Acute Psychosis as Main Manifestation of Central Pontine Myelinolysis". Case Rep Neurol Med. 2017: 1471096. doi:10.1155/2017/1471096. PMC 5368399. PMID 28392953.

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