What is Myelinolysis?

“Myelinolysis” means that the myelin — the covering that protects nerve cells, including the pontine nerve cells — is being destroyed. The destruction of myelin is generally not spontaneous. CPM usually happens as a result of another illness or medical condition.

How is Pontine Myelinolysis diagnosis?

Brain MRI reveals intense symmetric demyelination in the brain stem pons. The most consistent examination findings are those of pseudobulbar palsy and spastic quadriplegia caused by demyelination of corticospinal and corticobulbar tracts within the pons. The volume of demyelination within the pons is variable.

What happens in central pontine Myelinolysis?

Central pontine myelinolysis (CPM) is a neurological disorder that most frequently occurs after too rapid medical correction of sodium deficiency (hyponatremia). The rapid rise in sodium concentration is accompanied by the movement of small molecules and pulls water from brain cells.

What are the symptoms of central pontine Myelinolysis?

Symptoms may include any of the following:

• Confusion, delirium, hallucinations.
• Balance problems, tremor.
• Problem swallowing.
• Reduced alertness, drowsiness or sleepiness, lethargy, poor responses.
• Slurred speech.
• Weakness in the face, arms, or legs, usually affecting both sides of the body.

Can a pons stroke heal?

Recovery from a pontine stroke is possible. If you have experienced a pontine stroke, once your symptoms stabilize over time, the focus of your recovery will be based on preventing complications such as choking and preventing further strokes from happening.

Can you recover from osmotic demyelination syndrome?

The disorder can resolve completely or result in permanent disability or death. This typical clinical course has been called the osmotic demyelination syndrome (ODS).

What happens when you correct hyponatremia too quickly?

But new evidence shows that when patients with hyponatremia get admitted to the hospital, their impatient treatment teams often correct sodium levels too quickly, increasing the risk for dangerous complications. Too-rapid correction of sodium can cause osmotic demyelination syndrome (ODS), a form of brain damage.

What happens if you correct Hypernatremia too quickly?

Organic osmolytes accumulated during the adaptation to hypernatremia are slow to leave the cell during rehydration. Therefore, if the hypernatremia is corrected too rapidly, cerebral edema results as the relatively more hypertonic ICF accumulates water.

What causes pontine strokes?

The fluctuating course of stereotyped symptoms with a patent basilar artery suggested occlusion of the proximal portion or the ostium of a single basilar branch (branch disease). This is one of the most common mechanisms causing pontine strokes.

Does the pons control blood pressure?

The results in the present study suggest that the pons is responsible for the poststroke elevation in blood pressure following cerebrovascular events.

Is osmotic demyelination syndrome fatal?

Osmotic demyelination syndrome (ODS) is a rare, preventable, and potentially fatal complication of rapid correction of hyponatremia.

What does myelinolysis mean in medical terms?

[mī′əlinol′isis] Etymology: Gk, myelos + lysein, to loosen. a pathological process that dissolves the myelin sheaths around certain nerve fibers, such as those of the pons in alcoholic and undernourished people who are afflicted with central pontine myelinolysis.

What do you need to know about central pontine myelinolysis?

Definition Central pontine myelinolysis (CPM) is a neurological disorder that most frequently occurs after too rapid medical correction of sodium deficiency (hyponatremia). The rapid rise in sodium concentration is accompanied by the movement of small molecules and pulls water from brain cells.

Which is the best treatment for myelinolysis?

The ideal treatment for myelinolysis is to prevent the disorder by identifying individuals at risk and following careful guidelines for evaluation and correction of hyponatremia. These guidelines aim to safely restore the serum sodium level, while protecting the brain.

What happens to nerve cells in myelinolysis?

Nerve cells (neurons) can also be damaged. Certain areas of the brain are particularly susceptible to myelinolysis, especially the part of the brain stem called the pons. Some individuals will also have damage in other areas of the brain, which is called extrapontine myelinolysis (EPM).