Document Detail


Current perspectives in the management of hyponatremia: prevention of CPM.
MedLine Citation:
PMID:  18052771     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Central pontine myelinolysis represents a relatively contemporary neurologic entity in which an imbalance of water relative to alterations in the body's electrolyte levels induces characteristic demyelination in the central part of the basis pontis as well as extrapontine sites. The clinical scenario is typically one of chronic hyponatremia followed by a rapid correction to normonatremic or hypernatremic levels. This seemingly innocuous series of events can result in fatal consequences. Better understanding of the pathophysiology of this disorder provides avenues for clinical management, including use of steroids and organic osmoles, such as myoinositol. More recently, the introduction of a newer class of pharmacologic agents - the vasopressin receptor antagonists, known as vaptans, which induce an excretion of increased amounts of water without altered sodium or potassium excretion - is of particular interest. This review addresses classic approaches to the management of this disorder along with a discussion of newer pharmacologic agents that may become important therapeutic interventions in the clinical management of the osmotic myelinolysis syndrome.
Authors:
Richard H Sterns; Stephen Silver; B K Kleinschmidt-DeMasters; Amyn M Rojiani
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Expert review of neurotherapeutics     Volume:  7     ISSN:  1744-8360     ISO Abbreviation:  Expert Rev Neurother     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-06     Completed Date:  2008-01-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101129944     Medline TA:  Expert Rev Neurother     Country:  England    
Other Details:
Languages:  eng     Pagination:  1791-7     Citation Subset:  IM    
Affiliation:
Department of Medicine, Rochester General Hospital, University of Rochester School of Medicine, Rochester, NY, USA. richard.stern@viahealth.org
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MeSH Terms
Descriptor/Qualifier:
Animals
Humans
Hyponatremia / complications,  physiopathology*,  therapy*
Myelinolysis, Central Pontine / etiology,  physiopathology*,  prevention & control*

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