CCNAPI Newsletter at a rapid ( 0.5 mEq/L/hour) rate may be more dangerous than hyponatremia itself,resulting in central pontine and extrapontine myelinolysis manifested by http://www.filnurse.com/ccnapi/01mar4.html
Extractions: CCNAPI NEWSLETTER Vol. 10 No. 1 Mar 2001 ABSTRACTS FROM THE THE 5TH ANNUAL CONVENTION Central Nervous System...Continued from page 3 MANAGEMENT CONSIDERATIONS Cerebral edema of type I diabetic ketoacidosis Often a potentially preventable complication of treatment of DKA. It is easier to prevent than to treat. Asymptomatic increase in brain size during treatment of DKA is rule rather then an exemption Worsening cerebral function (headache, lethargy, irritability, combativeness, responsiveness) with improving biochemical parameters is characteristic Early recognition and prompt management can successfully reverse encephalopathy. Conversely, if untreated, early manifestations may rapidly progress to seizures, respiratory arrest, brain herniation, and death. Associated with hypotonic fluid overload and rapid decrease in serum osmolality Therapeutic pitfalls in dehydration of patient with DKA: Underestimation: hyperosmolality (traditional teaching) Overestimation: hyperventilation - dry lips and mouth
Conditions And Diseases: E | Treasure Coast Health Erythema Multiforme@ (3); Erythromelalgia@ (4); Esophageal Diseases@ (47); EssentialTremor@ (3); extrapontine myelinolysis@ (3); Eye Cancer@ (14). Our Sponsers. http://treasurecoasthealth.com/treasurecoasthealth.php/Health/Conditions_and_Dis
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ffÊgbv aberrant right subclavian artery. central pontine myelinolysis (CPM) +extrapontine myelinolysis (EPM). L4/5 . L5/S1 . http://www.yodosha.co.jp/fujiwara/sample/data/diagnosis/topj.html
Chang Gung Memorial Hospital Central and extrapontine myelinolysis in a patient in spite of a careful correctionof hyponatremia. Clin Nephrol 2001;5524853. 15. Pirzada NA, Ali II. http://www.cgmh.org.tw/eng2002/mag_mj/mag_mj_25_1207.htm
Extractions: CASE REPORT This 44-year-old woman, a housewife, was admitted because of hyponatremia and disturbed consciousness. She had no liver disease and never drank alcohol. She also denied any history of using diuretics. She had a history of postpartum hemorrhage which had occurred 13 years previous. Amenorrhea and failure to lactate developed thereafter. Fatigue and cold intolerance were also found. She neglected these problems and received no treatment. She lived an uneventful life until 1 day prior to this admission when she suffered from vomiting and diarrhea. Drowsiness developed the next day. She was then sent to our hospital for further management.
Les Troubles Métaboliques Translate this page 7. Karp BI, Laureno R. Pontine and extrapontine myelinolysis a neurologicdisorder following rapid correction of hyponatremia. http://www.oncorea.com/Livres/Livre01/ch13.htm
Extractions: Les complications métaboliques Les troubles métaboliques associés aux affections néoplasiques sont nombreux et variés et certains peuvent conduire le patient à lUSI dans un contexte de grande urgence (1). Lhypercalcémie Très fréquente, lhypercalcémie est causée soit par des métastases osseuses, soit par un syndrome paranéoplasique (2). Le tableau clinique débutera par une polyurie et de la soif et évoluera vers la déshydratation, les nausées et vomissements, les troubles du comportement, la confusion et les troubles de la conscience. Il faudra envisager le transfert du patient en réanimation si la calcémie est supérieure à 14 mg/dl ou si le malade présente des arythmies cardiaques, de linsuffisance cardiaque ou des troubles de la conscience. Le traitement (3) consiste dune part à réhydrater le patient en 24 à 48 heures avec du sérum physiologique et en suivant la diurèse et lionogramme et dautre part à administrer après réhydratation un biphosphonate (acide zolédronique 4 mg) pour bloquer la lyse osseuse. En cas dextrême urgence, de la calcitonine sera injectée pour avoir un contrôle très rapide de la calcémie. Lhyponatrémie Lacidose lactique Si elle sobserve le plus souvent dans le contexte dhypoxie tissulaire (choc de toute cause, sepsis) ou dune insuffisance hépatique fulminante, lacidose lactique peut être due à laffection néoplasique, quil sagisse dune hémopathie maligne
Center For Children With White Matter Disorders Central pontine and extrapontine myelinolysis Vitamin B12 deficiency Folate deficiencyMarchiafavaBignami disease Malnutrition Toxic encephalopathies http://www.vumc.nl/whitematter/classification.html
Extractions: Classification of white matter disorders I n the classification of white matter disorders, the first big divider is whether the disease is inherited or not. This difference has major implications for the tests to be performed, for risk of recurrence in the family, and for potential therapeutic strategies. The causes of the acquired forms can be subdivided according to type of cause into infectious-inflammatory, noninfectious-inflammatory, toxic-metabolic, traumatic and hypoxic-ischemic Hereditary disorders Lysosomal disorders Metachromatic leukodystrophy
AnsMe Directory - Health > Conditions And Diseases > E Erythema Infectiosum. Erythema Multiforme. Erythromelalgia. Esophageal Diseases.Essential Tremor. extrapontine myelinolysis. Eye Cancer. Submit Site. http://dir.ansme.com/health/43347.html
Extractions: por el poeta Juan Ramón Jiménez Este artículo se publicó en papel en Revista de Neurología ; La referencia es la siguiente: D. Ezpeleta. Descripción del síndrome pseudobulbar por el poeta Juan Ramón Jiménez. Rev Neurol 1998; 27: 122-124 [ MEDLINE Léalo, es un artículo muy especial... Resumen Se presenta un caso de síndrome pseudobulbar que se ha identificado en uno de los personajes de una obra clásica de la literatura española, Platero y yo , de Juan Ramón Jiménez. En este poema en prosa, se puede apreciar que Darbón, el "médico" de Platero, padece los síntomas de un síndrome pseudobulbar típico; disartria, disfagia e incontinencia emocional. Se revisa escuetamente el síndrome pseudobulbar, así como otros antecedentes de descripciones de enfermedades neurológicas en la literatura clásica española no médica. Abstract We present a case of pseudo-bulbar syndrome, identified in one of the characters of a classic of Spanish literature, Platero y yo by Juan Ramon Jimenez. In this prose poem, it can be seen that Darbon, Platero's 'doctor' has the symptoms of a typical pseudo-bulbar syndrome: dysarthria, dysphagia and emotional incontinence. The pseudo-bulbar syndrome is briefly reviewed, as are other descriptions of neurological syndromes in the non-medical classical Spanish literature.
Paper 19 - Postoperative Hyponatraemia pontine myelinolysis (CPM) or to a related and more diffuse condition known asosmotic demyelination syndrome, 9 or pontine and extrapontine myelinolysis. http://www.nda.ox.ac.uk/wfsa/dl/html/papers/pap019.htm
Extractions: Summary Hyponatraemia is a common and potentially dangerous metabolic perturbation in hospitalised patients. This essay reviews the aetiology, pathology and treatment of acute, severe postoperative hyponatraemia. It is not a comprehensive review article, but is a review of the literature based on a Medline search using the Medline database in English for the last 20 years. Major mesh headings of hyponatraemia, aetiology, pathophysiology and therapy were used, and human and animal studies were included. No meta-analysis of treatment options and outcomes was found in the literature that was surveyed. Although some studies were prospective, there were no controlled nor randomised studies found on this subject. Introduction Hyponatraemia is the most common electrolyte abnormality in hospitalised patients Its prevalence depends on which source one reads, but for hospitalised patients range estimates are that:
Extractions: (advertisement) Synonyms, Key Words, and Related Terms: osmotic myelinolysis Background: Adams et al described central pontine myelinolysis (CPM) as a unique clinical entity. They published their findings in 1958, observing that patients who suffered from alcoholism or malnutrition developed spastic quadriplegia, pseudobulbar palsy, and varying degrees of encephalopathy or coma from acute, noninflammatory demyelination that centered within the basis pontis. Contemporary physicians recognize that CPM occurs inconsistently as a complication of severe and prolonged hyponatremia, particularly when corrected too rapidly. Standard of care requires judicious treatment of electrolyte disturbances to reduce the incidence of osmotic myelinolysis. Pathophysiology: CPM is concentrated, frequently symmetric, noninflammatory demyelination within the central basis pontis. In at least 10% of patients with CPM, demyelination also occurs in extrapontine regions, including the mid brain, thalamus, basal nuclei, and cerebellum. The exact mechanism that strips the myelin sheath is unknown. One theory proposes that in regions of compact interdigitation of white and gray matter, cellular edema, which is caused by fluctuating osmotic forces, results in compression of fiber tracts and induces demyelination. Prolonged hyponatremia followed by rapid sodium correction results in edema. During the period of hyponatremia, the concentration of intracellular charged protein moieties is altered; reversal cannot parallel a rapid correction of electrolyte status. The term "osmotic myelinolysis" is more appropriate than "central pontine myelinolysis" for demyelination occurring in extrapontine regions after the correction of hyponatremia.
Central Pontine Myelinolysis sometimes be present. extrapontine sites of myelinolysis in the basalganglia and midbrain, and subcortical white matter may also occur. http://www.amershamhealth.com/medcyclopaedia/Volume VI 1/CENTRAL PONTINE MYELINO
Extractions: *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
Central Pontine Myelinolysis Was First Described By Adams Et Al... myelinolysis in the pons is frequently associated with demyelination in other areasof These extrapontine lesions are thought to coexist with CPM in 10% of the http://www.indegene.com/Gen/ClinRound/indGenCase19.html
Extractions: 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.
Issues: Volume 102: January - December 1979: Issue 2: June 1979 ED . Bird , ES . Spokes and LL . Iversen Pages 347 360. Pontine and extrapontinemyelinolysis. DG . Wright , R . Laureno and M . Victor Pages 361 - 386. http://www3.oup.co.uk/jnls/supplements/braini/hdb/Volume_102/Issue_02/
Extractions: CJ Vierck Jr and MM Luck Pages: DH Becker JJ Townsend RA Kramer and TH Newton Pages: M Kaarsoo Herrick and LJ Ribinstein Pages: SZ Stefanko and WA Manschot Pages: EGS Spokes Pages: ED Bird ES Spokes and LL Iversen Pages: DG Wright R Laureno and M Victor Pages: JA Sharpe AW Lo and HE Rabinovitch Pages: E Knutsson and C Richards Pages: Part of the OUP Brain WWW service Click here to register with OUP.
Thammasat Medical Journal ? 3 ? Central Pontine and ExtrapontineMyelinolysis A study of 3 cases in Ramathibodi hospital. http://www.med.tu.ac.th/Journal/journal2_2.html
úåãwG@2000N5E59ª5 The summary for this Japanese page contains characters that cannot be correctly displayed in this language/character set. http://www.med.nihon-u.ac.jp/department/NUMA/No59-5/MRI.html
David B Methylphenidate Treatment of Neuropsychiatric. Symptoms of Central and ExtrapontineMyelinolysis. Journal of Studies on Alcohol, 61657660, 2000. 12. http://www.uchsc.edu/sm/psych/dept/faculty/arciniegas_d.htm
Extractions: To conact, e-mail: David.Arciniegas@UCHSC.edu RESEARCH AND PROFESSIONAL EXPERIENCE: Experience: 1992 1993 Internship in Community Medicine, University of Colorado Health Sciences Center (UCHSC) 1993 1996 Residency in Adult Psychiatry, UCHSC 1995 1996 Chief Resident in Consultation-Liaison Psychiatry, UCHSC 1996 1998 Instructor/Fellow in Psychiatry, UCHSC 1996 1999 Fellowship in Neuropsychiatry and Clinical Neuroscience Research, UCHSC 1996 1999 Fellowship in Neuroscience Research and Traumatic Brain Injury, Denver VAMC 1996 1998 Associate Director of Medical Student Education, Department of Psychiatry, UCHSC 1997 Director, Neuroscience Course, Adult Psychiatry Residency Training Program, UCHSC 1998 1999 Instructor/Fellow in Psychiatry and Neurology, UCHSC 1998 Member, Behavioral Neurology Section, Department of Neurology, UCHSC 1998 Director of Medical Education, Colorado Mental Health Institute at Pueblo, Pueblo, CO
Clinical Nephrology, Vol. 55, 3/01 Contents. Clinical Nephrology, Vol. 55, No. 3/2001 (248253). Central and extrapontinemyelinolysis in a patient in spite of a careful correction of hyponatremia. http://www.clinnephrol.com/dustri/31nephrology/31cn0103.htm
[Dysphagia] CPM Here are a couple of abtracts that may be useful Central Pontine and ExtrapontineMyelinolysis After Correction of Hyponatremia Neurologist 2000 ;6255266 http://www.b9.com/dysphagia/2002-July/msg00370.html
