Central pontine myelinolysis natural history, complications and prognosis

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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

The symptoms of central pontine myelinolysis typically develop immediately after injury to the neurons of the brain stem. Patients, with Central Pontine Myelinolysis, may develop permanent neurological damages. Common complications of central pontine myelinolysis include: Locked-in syndrome, quadriparesis, ataxia, acute Psychosis, pseudobulbar palsy, parkinson's disease symptoms, dystonia, pneumonia, coma and death. The mortality of patients with central pontine myelinolysis is approximately 8% in the acute setting. Approximately 65% of patients with central pontine myelinolysis may achieve a good or moderate outcome (no functional deficit or independence despite minor deficits). Depending on the time of the diagnosis, the prognosis may vary and the disease may be potentially reversible when therapeutic interventions are initiated rapidly.

Natural History, Complications, and Prognosis

Natural History

  • The symptoms of central pontine myelinolysis typically develop immediately after injury to the neurons of the brain stem.

Complications

  • Patients, with Central Pontine Myelinolysis, may develop permanent neurological damages.

Prognosis

  • The mortality of patients with central pontine myelinolysis is approximately 8% in the acute setting.[7]
  • Approximately 65% of patients with central pontine myelinolysis may achieve a good or moderate outcome (no functional deficit or independence despite minor deficits).[8][7]
  • Depending on the time of the diagnosis, the prognosis may vary and the disease may be potentially reversible when therapeutic interventions are initiated rapidly.[9]

References

  1. ↑ Sohn MK, Nam JH (2014). "Locked-in Syndrome due to Central Pontine Myelinolysis: Case Report". Ann Rehabil Med. 38 (5): 702–6. doi:10.5535/arm.2014.38.5.702. PMC 4221401. PMID 25379502.
  2. ↑ 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.
  3. ↑ Pfister HW, Einhäupl KM, Brandt T (1985). "Mild central pontine myelinolysis: a frequently undetected syndrome". Eur Arch Psychiatry Neurol Sci. 235 (3): 134–9. PMID 4092709.
  4. ↑ Dolciotti C, Nuti A, Cipriani G, Borelli P, Baldacci F, Logi C; et al. (2010). "Cerebellar ataxia with complete clinical recovery and resolution of MRI lesions related to central pontine myelinolysis: case report and literature review". Case Rep Neurol. 2 (3): 157–62. doi:10.1159/000323429. PMC 3098816. PMID 21607027.
  5. ↑ Seiser A, Schwarz S, Aichinger-Steiner MM, Funk G, Schnider P, Brainin M (1998). "Parkinsonism and dystonia in central pontine and extrapontine myelinolysis". J Neurol Neurosurg Psychiatry. 65 (1): 119–21. doi:10.1136/jnnp.65.1.119. PMC 2170170. PMID 9667573.
  6. ↑ Grech R, Galvin L, Brennan P, Thornton J (2013). "Central pontine myelinolysis". BMJ Case Rep. 2013. doi:10.1136/bcr-2013-008920. PMC 3645781. PMID 23608854.
  7. ↑ 7.0 7.1 Graff-Radford J, Fugate JE, Kaufmann TJ, Mandrekar JN, Rabinstein AA (2011). "Clinical and radiologic correlations of central pontine myelinolysis syndrome". Mayo Clin Proc. 86 (11): 1063–7. doi:10.4065/mcp.2011.0239. PMC 3202996. PMID 21997578.
  8. ↑ Menger H, Jörg J (1999). "Outcome of central pontine and extrapontine myelinolysis (n = 44)". J Neurol. 246 (8): 700–5. doi:10.1007/s004150050435. PMID 10460448.
  9. ↑ Rebedew DL (2016). "Is Central Pontine Myelinolysis Reversible?". WMJ. 115 (6): 326–8. PMID 29095576.

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