21. Health Ency.: Disease: Central Pontine Myelinolysis central pontine myelinolysis. There is no known cure for central pontinemyelinolysis and treatment is focused on relieving symptoms. http://www.accessatlanta.com/shared/health/adam/ency/article/000775trt.html

SEARCH: The Web Yellow Pages HOME AJC.COM Illustrated Health Encyclopedia Important notice Ency. home Disease C Central pontine myelinolysis Overview Symptoms Treatment Prevention Treatment This is an emergency disorder that requires hospitalization for initial diagnosis and treatment. There is no known cure for central pontine myelinolysis and treatment is focused on relieving symptoms. Double vision may be reduced with the use of an eye patch. Physical therapy, may help maintain muscle strength, mobility, and function in weakened arms and legs. Prognosis The neurologic damage caused by central pontine myelinolysis is usually persistent. The disorder can cause serious chronic disability. Complications Permanent neurologic losses Decreased ability to work or care for self Decreased ability to interact with others Call Your Health Care Provider If: Go to the emergency room or call the local emergency number (such as 911) if seizures muscle weakness , or other symptoms of central pontine myelinolysis occur. Ency. home Disease C Please read this Important notice Also Check Out Subscribe to The Atlanta Journal-Constitution Home Autos Classifieds ... Our Sponsors By using AccessAtlanta.com you accept the terms of our

22. Central Pontine Myelinolysis central pontine myelinolysis,, Print this article, central pontine myelinolysis,Fig. 1 MR, T2weighted axial image of the posterior fossa. http://www.amershamhealth.com/medcyclopaedia/Volume VI 1/CENTRAL PONTINE MYELINO

Medcyclopaedia About Medcyclopaedia Amersham Health Search for: Type a word or a phrase. All forms of the word are searchable. Advanced search Browse entry words starting with: A B C D ... Other characters Try our Medcyclopaedia Premium Edition with added tools and functionality tailored to make your working day easier. The following tools are presently available: Expanded search *For Medical Professionals only, registration required Central pontine myelinolysis, (also called osmotic demyelination), demyelinating disorder found in alcoholics or in association with many systemic disorders with electrolyte abnormalities. Because of the common association with rapidly corrected hyponatraemia, the term "osmotic demyelination syndrome" has been proposed. The symptoms of central pontine myelinolysis are quadriparesis, pseudobulbar palsy and changing levels of consciousness, including coma and death. Histologically, the area of myelin breakdown is sharply demarcated and displays extensive loss of oligodendrocytes, infiltration with foamy macrophages and reactive astrocytosis. At MR the lesion is characterized by T2 hyperintensity in a central pontine location ( Fig.1

23. Central Pontine Myelinolysis central pontine myelinolysis. Definition The most common cause of central pontinemyelinolysis is a rapid, drastic change in sodium levels in the body. http://www.pennhealth.com/ency/article/000775.htm

Disease Injury Nutrition Poison ... Prevention Central pontine myelinolysis Definition: Central pontine myelinolysis is a condition characterized by nerve damage caused by the destruction of the covering layer ( myelin sheath) of nerve cells in the brainstem (pons). Alternative Names: CPM Causes, incidence, and risk factors: The destruction of the myelin sheath that coats nerves inhibits impulse conduction within the cell and thus decreases its ability to communicate with other cells. The most common cause of central pontine myelinolysis is a rapid, drastic change in sodium levels in the body. Most commonly, this occurs when someone is being treated for low levels of sodium ( hyponatremia ) and the levels rise too fast, but it can occasionally occur when high levels of sodium in the body (hypernatremia) are corrected too quickly. This condition does not occur spontaneously; it is a complication of either treatment for other conditions or the other conditions themselves. Risks include hyponatremia from any cause. Alcoholism Wernicke-Korsakoff syndrome , and general ill health and malnutrition associated with serious illnesses (cachexia) increase the risk of central pontine myelinolysis.

24. Central Pontine Myelinolysis central pontine myelinolysis. Alternative Names CPM. There is no known cure forcentral pontine myelinolysis and treatment is focused on relieving symptoms. http://www.pennhealth.com/ency/article/000775trt.htm

Disease Injury Nutrition Poison ... Prevention Central pontine myelinolysis Alternative Names: CPM Treatment: This is an emergency disorder that requires hospitalization for initial diagnosis and treatment. There is no known cure for central pontine myelinolysis and treatment is focused on relieving symptoms. Double vision may be reduced with the use of an eye patch. Physical therapy may help maintain muscle strength, mobility and function in weakened arms and legs. Expectations (prognosis): The neurologic damage caused by central pontine myelinolysis is usually persistent. The disorder can cause serious chronic disability. Complications: Permanent neurologic losses Decreased ability to work or care for self Decreased ability to interact with others Calling your health care provider: Go to the emergency room or call the local emergency number (such as 911) if seizures muscle weakness , or other symptoms of central pontine myelinolysis occur. Review Date: 7/28/2002 Reviewed By: Elaine T. Kiriakopoulos, M.D., MSc, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA. Review provided by VeriMed Healthcare Network.

25. Singapore Medical Journal In a patient with a history of sodium replacement, this finding is in keepingwith osmotic myelinolysis (or central pontine myelinolysis). http://www.sma.org.sg/smj/4101/articles/4101me1ans.htm

Journals Present Issue Past Issues THESMANEWS Present Issue Past Issues SMJ Editorial Board Letters to the Editor Instructions to Authors S I N G A P O R E M E D I C A L J O U R N A L This site is supported by Health ONE Singapore Med J 2000; Vol 41(1): Clinics in Diagnostic Imaging (45) C Y Chan, H S Lam, J R Jinkins IMAGE INTERPRETATION MR scans showede a 1 cm area of T2 hyperintensity in the central pontine region (Fig 1a) . In a patient with a history of sodium replacement, this finding is in keeping with osmotic myelinolysis (or central pontine myelinolysis). Multiple areas of T2 hyperintensity were seen in the basal ganglia and deep white matter (Fig 1b) , representing part of the same process. DIAGNOSIS Osmotic myelinolysis (central pontine myelinolysis) CLINICAL COURSE The patient did not improve clinically over the following months. She developed spastic tetraparesis, pseudobulbar palsy and horizontal nystagmus. Because of mutism, antidepressants were tried but they were not effective. She remained bed-ridden and ventilator-dependent. During her hospital stay, she developed several episodes of chest and urinary tract infection which were controlled with antibiotics. The patient finally died one year later due to multiple organ failure and sepsis. DISCUSSION Osmotic myelinolysis (OM) is a demyelinating disease that can develop following rapid correction of hyponatremia from any cause. It was originally described in chronic alcoholics. Other reported associations include malnourished status, renal failure, diabetes mellitus, and post-orthotopic liver transplantation

26. REFERENCES central pontine myelinolysis clinical and MRI correlates. Postgrad Med J 1995;7143042. Reversal of MR findings of central pontine myelinolysis. http://www.sma.org.sg/smj/4101/references/4101me1ref.htm

REFERENCES Ho VB, Fitz CR, Yoder CC, Geyer CA. Resolving MR features in osmotic myelinolysis (central pontine and extrapontine myelinolysis). AJNR 1993; 14:163-7. Martin PJ, Young CA. Central pontine myelinolysis: clinical and MRI correlates. Postgrad Med J 1995; 71:430-42. Laaureno R, Karp BI. Myelinolysis after correction of hyponatremia. Ann Intern Med 1997; 126:57-62. McGraw P, Edwards-Brown MK. Reversal of MR findings of central pontine myelinolysis. J Comput Assist Tomogr 1998; 22:989-91. Gregorio L, Sutton CL, Lee DA. Central pontine myelinolysis in a previously healthy 4-year-old child with acute rotavirus gastroenteritis. Pediatrics 1997; 99:738-43. Karp BI, Laureno R. Pontine and extrapontine myelinolysis: a neurologic disorder following rapid correction of hyponatremia. Medicine (Baltimore) 1993; 72:359-73. Korogi Y, Takahashi M, Shinzato J, Sakamoto Y, Mitsuzaki K, Hirai T, et al. MR findings in two presumed cases of mild central pontine myelinolysis. AJNR 1993; 14:651-4. Gocht A, Colmant HJ. Central pontine and extrapontine myelinolysis: a report of 58 cases. Clin Neuropathol 1987; 6:262-70.

27. Central Pontine Myelinolysis Return to Index. http://www.nemcrad.com/neuro/Diseases/CentralPontineMyelinolysis.html

Return to Index Return to Index

28. Central Pontine Myelinolysis - General Practice Notebook Notebook. central pontine myelinolysis. central pontine myelinolysis(CPM) is a rare demyelinating condition of the pons affecting long http://www.gpnotebook.co.uk/cache/-1583742920.htm

central pontine myelinolysis Central pontine myelinolysis (CPM) is a rare demyelinating condition of the pons affecting: long tract fibres pontocerebellar fibres pontine nuclei CPM is associated with: chronic alcoholism over-rapid correction of hyponatraemia There is no treatment. Click here for more information...

29. Central Pontine Myelinolysis A Complication Of Hyponatremia Or Of Therapeutic In Pages 444451 Author(s) Haibach H, Ansbacher LE, Dix JD Title Central PontineMyelinolysis A Complication of Hyponatremia or of Therapeutic Intervention? http://www.astm.org/JOURNALS/FORENSIC/PAGES/837.htm

Citation Information Stock #: Volume: Issue: Year: Pages: Author(s): Haibach H, Ansbacher LE, Dix JD Title: Central Pontine Myelinolysis A Complication of Hyponatremia or of Therapeutic Intervention? Keywords: alcoholism, central pontine myelinolysis, forensic science, hypernatremia, hyponatremia, hypothermia, malnutrition, pathology and biology, saline infusion Abstract: We report four cases of central pontine myelinolysis (CPM) that illustrate important features of the disorder. The condition is described mainly in the neurological literature and, to our knowledge, is not discussed in the forensic science journals. This disorder must be recognized and understood by the forensic science expert who addresses issues of liability. In cases of multiple motor deficits and death with a history of hyponatremia, CPM must be included in the differential diagnosis. Careful examination of the pons and adjoining structures must be performed. Myelin stains are advisable. The association of CPM with major illnesses, hyponatremia and the correction of hyponatremia by intravenous saline infusions is discussed. *PDF not available Return to Main Page

30. NDI Terminology - Central Pontine Myelinolysis central pontine myelinolysis. DEFINITION Definition has yet to beentered. Check back later. The definitions used in this glossary http://www.ndif.org/Terms/central_pontine_myelinolysis.html

central pontine myelinolysis DEFINITION: Definition has yet to be entered. Check back later. The definitions used in this glossary of terminology either have been provided by the authors of the articles, or have been extracted wholly or in part, or paraphrased from the following sources: The American Medical Association Encyclopedia of Medicine , Charles B. Clayman, MD, Medical Editor, Random House, New York, 1989; Dorland's Illustrated Medical Dictionary , 28th Edition, W. B. Saunders Company, Philadelphia, 1994; The Random House Dictionary of the English Language , Unabridged Edition, 1966; Webster's Ninth New Collegiate Dictionary TERMINOLOGY WHERE THIS WORD IS USED TABLE of CONTENTS INFO. REQUEST ENTRANCE

31. Central Pontine Myelinolysis Was First Described By Adams Et Al... central pontine myelinolysis Following Hemodialysis. Author Dr RDewan, Dr Rahul Rai, Dr Praveen Gupta, Dr Rahul Anand, Dr Pankaj http://www.indegene.com/Gen/ClinRound/indGenCase19.html

Central Pontine Myelinolysis Following Hemodialysis Author: Dr R Dewan, Dr Rahul Rai, Dr Praveen Gupta, Dr Rahul Anand, Dr Pankaj Mehta, Dr Sameer Gulati Hospital: Depatment of Medicine, Maulana Azad Medical College, New Delhi Introduction Central pontine myelinolysis was first described by Adams et al in 1959 during the course of studying the neuropathology of alcoholism. The lesion was localized to the central rostral part of the pons and consisted of a sharply outlined focus of myelin destruction. Quadriplegia and pseudobulbar palsy were the main clinical findings. CPM was usually a postmortem diagnosis till the advent of the CT and the MRI. We report this interesting case of a young lady who developed CPM following hemodialysis. Case Report A young 26-year-old lady, a diagnosed case of Hypertension with MPGN with Chronic Renal Failure, was admitted with complaints of sudden onset loss of consciousness. The patient had developed altered sensorium 4 days before presentation, for which she was taken to a private nursing home and was hemodialysed twice. Following dialysis she developed drooping of the right eyelid and progressive paraparesis. Following this the patient developed loss of consciousness, when she was brought to our hospital. There was no other significant history. On examination the patient was unconscious, not responding to painful stimulus and a blood pressure of 180/130. The general physical examination showed pallor and facial puffiness but no icterus, clubbing or lymphadenopathy. Chest, CVS and per abdomen examination was normal. CNS examination revealed deep comatose state, a right third nerve palsy, paraparesis, which later progressed to quadriparesis, with bilateral up-going plantars.

32. Health Library Find Information On Central Pontine Myelinolysis Find information on central pontine myelinolysis at MerckSource. Learnmore central pontine myelinolysis. Definition Central pontine http://www.mercksource.com/pp/us/cns/cns_hl_adam.jspzQzpgzEzzSzppdocszSzuszSzcns

33. Myelinolysis, Central Pontine Thesaurus Advanced Search Registration Help Disclaimer Myelinolysis,Central Pontine. Image URL central pontine myelinolysis, http://www.brisbio.ac.uk/ROADS/subject-listing/myelinolysiscentralpontine.html

A collection of medical, dental and veterinary images for use in teaching. Home About the Archive FAQ Terms and Conditions ... Help Myelinolysis, Central Pontine Central pontine myelinolysis

34. Central And Extrapontine Myelinolysis Following Allogeneic Peripheral Haematopoi central pontine myelinolysis (CEPM) has been reported after orthotopic livertransplantation (OLT), being attributed to the use of CsA or to the rapid http://www.nature.com/cgi-taf/DynaPage.taf?file=/bmt/journal/v31/n1/full/1703781

35. Nature Publishing Group rapid correction or over correction of hyponatremia (a change in serum sodium 25mmol/l within 48 h) has been linked to central pontine myelinolysis (CPM) and http://www.nature.com/cgi-taf/DynaPage.taf?file=/sc/journal/v35/n5/abs/3100371a.

36. ÏÃÂê0282¡¡¿åÃæÆǤÈcentral Pontine Myelinolysis 0282 central pontine myelinolysis From hayakawa mineji To CCN@koto.kpum.ac.jp Subject CCN02392 http://www.kpu-m.ac.jp/CCN/topics/topics/w0282.html

ÏÂê0282¡¡¿åæÆǤÈcentral pontine myelinolysis From: "hayakawa mineji" Subject: [CCN:02392] ¿åæÆǤÈcentral pontine myelinolysis Date: Sun, 3 Dec 2000 03:09:17 +0900 MIME-Version: 1.0 X-Priority: 3 ¤½¤ÎºÝ¡¢Na¤ÎÊä½¼¤äÍøÇ¢Ìô¤ÎÅêÍ¿¤ò¹Ô¤ï¤Ê¤¯¤Æ¤â¾¡¼ê¤ËÍøÇ¢¤¬¤Ä¤¤¤ÆNa¤¬µÞ®¤Ë¾å¾º¤·¤Æ¤­¤Þ¤·¤¿¡£ ¶µ²Ê½ñŪ¤Ë¤ÏNa¤ÎµÞ·ã¤ÊÊäÀµ¤Ïcentral pontine myelinolysis¤ò°ú¤­µ¯¤³¤¹¤Î¤Ç¤æ¤¤¯¤ê¤È¹Ô¤¨¤ÈÍ­¤ë¤¬¡¢À¸ÂÎÈ¿±þ¤È¤·¤Æ¼«Á³¤ËÊäÀµ¤µ¤ì¤ë¾ì¹ç¤Ï¡¢¤É¤¦¤¹¤ì¤ÐÎɤ¤¤Î¤«? ¤ä¤Ï¤ê¡¢Na¤Î¾å¾º¤ò²¡¤µ¤¨¤Ê¤±¤ì¤Ð¤Ê¤é¤Ê¤¤¤Î¤«? ¼«Á³¤Ê·Ð²á¤Ç¤âcentral pontine myelinolysis¤¬È¯À¸¤¹¤ë¤È¤¤¤¤¿¾ÉÎã¤äÊó¹ð¤ò¸æ¸ΤÎÊý¤¬¤¤¤é¤¤·¤ã¤¤¤Þ¤·¤¿¤é¡¢¸æ¶µ¼ø´ê¤¤¤Þ¤¹¡£ From: "hayakawa mineji" Subject: [CCN:02394] RE:¿åæÆǤÈcentral pontine myelinolysis Date: Sun, 3 Dec 2000 23:00:40 +0900 N Engl J Med¡¡2000¡¢342¡¢1581-1589 Hyponatremia.¡¡ (ÄãNa·ì¾É¤Ë¤Ä¤¤¤ÆÎɤ¯¤Þ¤È¤Þ¤¤Æ¤¤¤ëʸ¸¥¤«¤È»×¤¤¤Þ¤¹¡£¡Ë osmotic demyelination is serious and can develop ¡Áæά¡Á including water restriction alone. ¤Þ¤¿¡¤¤³¤Î¤È¤­¤ÎÂбþ¡Ê¿åÉé²Ùor ADH or ¤½¤Î¾¡Ë¤Ë¤Ä¤¤¤Æ¤â¡¢¶µ¤¨¤Æ¤¤¤¿¤À¤±¤ì¤Ð¹¬¤¤¤Ç¤¹¡£

37. Myelinolysis Temporal changes of MR findings in central pontine myelinolysis. The lowest measuredsodium blood level was 121 mmol/l.. central pontine myelinolysis. http://rkaris.home.att.net/cpm.htm

documed Demyelinating diseases : Myelinolysis Clinical features Parkinsonism and dystonia in central pontine and extrapontine myelinolysis J Neurol Neurosurg Psychiatry 1998 Jul;65(1):119-21 Case report. Abnormal movements in a case of extrapontine myelinolysis. Review of the literature. Rev Neurol 1998 Feb;26(150):215-20 [chorea, dystonia, Parkinsonism] Central pontine myelinolysis: clinical presentation and radiologic findings Eur Radiol 1996;6(2):177-83 [The symptoms ranged from severe neurologic disorders to mild neurologic disturbances only. The size of the pontine lesion did not correlate with the severity of the neurologic illness or the final outcome.] Regressive dystonia and cerebellar ataxia: two unusual symptoms in central pontine myelinolysis J Neurol 1995 Jul;242(7):450-4 Central pontine myelinolysis with cerebellar ataxia and dystonia Rev Neurol (Paris) 1993;149(5):344-6 Electrolytes Central pontine myelinolysis: clinical syndrome with normal serum sodium Eur J Med Res 1995 Dec 18;1(3):168-70 Case report. Myelinolysis after correction of hyponatremia Ann Intern Med 1997 Jan 1;126(1):57-62

38. Health Content Encyclopedia Article Central Pontine Myelinolysis central pontine myelinolysis is a condition characterized by neurologic damage causedby the destruction of the covering layer (myelin sheath) of nerve cells http://www.baptisteast.com/adamcontent/ency/article/000775.asp

39. Cerebral Demyelination Syndrome Nephrology, Neurology, Sodium, Cerebral Demyelination Syndrome. CerebralDemyelination Syndrome central pontine myelinolysis. Book, Home http://www.fpnotebook.com/REN89.htm

Home About Links Index ... Editor's Choice Paid Advertisement (click above). Please see the privacy statement Nephrology Neurology Sodium Cerebral Demyelination Syndrome Cerebral Demyelination Syndrome Central Pontine Myelinolysis Book Home Page Cardiovascular Medicine Dental Dermatology Emergency Medicine Endocrinology Gastroenterology General Medicine Geriatric Medicine Gynecology Hematology and Oncology HIV Infectious Disease Jokes Laboratory Neonatology Nephrology Neurology Obstetrics Ophthalmology Orthopedics Otolaryngology Pediatrics Pharmacology Prevention Psychiatry Pulmonology Radiology Rheumatology Sports Medicine Surgery Urology Chapter Nephrology Index Acid and Base Disorders Calcium Chloride Cardiovascular Medicine Dermatology Edema Endocrinology Examination Failure Glomerulus Laboratory General Pulmonology Magnesium Neurology Pharmacology Phosphorus Potassium Radiology Sodium Surgery Tubule Page Neurology Index Sodium CPM See Also Hyponatremia Pathophysiology Lethal Cerebral edema from rapid electrolyte correction Over-correction of Serum Sodium Too rapid correction of Serum Sodium Related to chronicity of electrolyte disturbance Associated with rapid correction chronic Hyponatremia Not associated with correction of acute Hyponatremia Search other websites for this topic Search National Library of Medicine PubMed for related articles Search Google for related images or topics Paid Advertisement (click above). Please see the

40. Hyponatremia Management Risk of central pontine myelinolysis; Treat Hyponatremia based on SerumOsmolality (above); Do not use greater than normal saline (0.9%). http://www.fpnotebook.com/REN126.htm

Home About Links Index ... Editor's Choice Paid Advertisement (click above). Please see the privacy statement Nephrology Sodium Assorted Pages Hypernatremia Hypervolemic Hypernatremia Hypovolemic Hypernatremia Isovolemic Hypernatremia ... Cerebral Demyelination Syndrome Hyponatremia Management Book Home Page Cardiovascular Medicine Dental Dermatology Emergency Medicine Endocrinology Gastroenterology General Medicine Geriatric Medicine Gynecology Hematology and Oncology HIV Infectious Disease Jokes Laboratory Neonatology Nephrology Neurology Obstetrics Ophthalmology Orthopedics Otolaryngology Pediatrics Pharmacology Prevention Psychiatry Pulmonology Radiology Rheumatology Sports Medicine Surgery Urology Chapter Nephrology Index Acid and Base Disorders Calcium Chloride Cardiovascular Medicine Dermatology Edema Endocrinology Examination Failure Glomerulus Laboratory General Pulmonology Magnesium Neurology Pharmacology Phosphorus Potassium Radiology Sodium Surgery Tubule Page Sodium Index High High Hypervolemic High Hypovolemic High Isovolemic Low Low Hyperosmolar Low Normoosmolar Low Hypoosmolar Approach Low Hypoosmolar Hypervolemic Low Hypoosmolar Hypovolemic Low Hypoosmolar Isovolemic Low Hypoosmolar Isovolemic SIADH Low Management See Specific Hypontremia Management Protocols Hyperosmolar Hyponatremia Serum Osms Hypoosmolar Hyponatremia Serum Osms ... Serum Osms Chronic Hyponatremia Avoid too rapid correction of Serum Sodium Risk of Central Pontine Myelinolysis Treat Hyponatremia based on Serum Osmolality (above) Do not use greater than normal saline (0.9%)

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