Document Detail

Central pontine myelinolysis.
MedLine Citation:
PMID:  11803185     Owner:  NLM     Status:  MEDLINE    
Central pontine myelinolysis (CPM) is a demyelinating disease of the pons often associated with demyelination of other areas of the central nervous system (CNS). The term 'osmotic demyelinization syndrome' is used for pontine and extrapontine myelinolysis. In this paper, we are concerned with CPM although the extrapontine one is based on the same pathogenesis. Both share the diagnostic methods, and their prevention and therapy are the same. The etiology and pathogenesis of this disorder are unclear and will be discussed. However, almost all cases of CPM are related to severe diseases. Chronic alcoholism is still the most common underlying condition of CPM patients. In the literature, 174 cases of CPM have been reported in alcoholics since 1986, which is equivalent to an incidence of 39.4%. Likewise, 95 cases of CPM following the correction of hyponatremia have been documented since 1986 (21.5%). The role of hyponatremia and its correction will be outlined in the discussion of the pathogenesis of CPM. The third largest group of CPM cases are liver transplant patients (17.4%), with the development of CPM being attributed to the immunosuppressive agent cyclosporine in particular. Depending on the involvement of other CNS structures, the clinical picture can vary considerably. The large-scale introduction of magnetic resonance imaging has increasingly facilitated the antemortem diagnosis of CPM, although the radiological findings lag behind and do not necessarily correlate with the clinical picture. As yet, there is no specific therapy of choice. A number of therapeutic approaches have been tested and although they have not been compared with regard to their rate of success, they have all led to a substantial improvement in the prognosis of CPM.
Christian Lampl; Kambiz Yazdi
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  European neurology     Volume:  47     ISSN:  0014-3022     ISO Abbreviation:  Eur. Neurol.     Publication Date:  2002  
Date Detail:
Created Date:  2002-01-22     Completed Date:  2002-03-05     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0150760     Medline TA:  Eur Neurol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  3-10     Citation Subset:  IM    
Copyright Information:
Copyright 2002 S. Karger AG, Basel
Department of Neurology, Psychiatry and Pain Clinic, General Hospital Linz, Austria.
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MeSH Terms
Chronic Disease
Hyponatremia / therapy
Myelinolysis, Central Pontine / diagnosis,  etiology,  prevention & control*,  therapy*

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