What causes 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 happens when sodium is increased too fast?

Too-rapid correction of sodium can cause osmotic demyelination syndrome (ODS), a form of brain damage.

Is osmotic demyelination syndrome same as central pontine myelinolysis?

The neurologic manifestations associated with overly rapid correction have been called the osmotic demyelination syndrome (ODS; formerly called central pontine myelinolysis or CPM). As will be described below, almost all patients who develop ODS present with a serum sodium concentration of 120 mEq/L or less.

What does osmotic demyelination syndrome cause?

Osmotic demyelination syndrome (ODS) is brain cell dysfunction. It is caused by the destruction of the layer (myelin sheath) covering nerve cells in the middle of the brainstem (pons).

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.

Why is dextrose given in hypernatremia?

In patients with hypernatremia of longer or unknown duration, reducing the sodium concentration more slowly is prudent. Patients should be given intravenous 5% dextrose for acute hypernatremia or half-normal saline (0.45% sodium chloride) for chronic hypernatremia if unable to tolerate oral water.

Why do you give dextrose for hyponatremia?

A brief infusion of 5 % dextrose in water (D5W) re-lowers the serum sodium to a more acceptable level, representing a 10-mmol / l increase in 24 h.

What is osmotic Myelinolysis?

Osmotic myelinolysis (OM) is an acute, non-inflammatory demyelinating disease that can develop following rapid correction of hyponatremia from any cause.

Can hyponatremia cause pontine myelinolysis?

Central pontine myelinolysis is a rare neurologic condition most frequently caused by the rapid correction of hyponatremia.