Idiopathic central pontine myelinolysis in childhood

Menakaya, J O; Wassmer, E; Bradshaw, Karen; Seri, Stefano; Whitehouse, William

doi:10.1111/j.1469-8749.2001.tb00144.x

Cited by 4 publications

(9 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[16] as well as between extent of lesions on MRI and clinical severity of subsequent presentation or clinical outcome. [16] Abnormal radiological results may be found despite evident clinical improvement or after resolution of clinical symptoms or else they may resolve despite the presence of clinical neurological symptoms. [16] The imaging features are due to increased water content in the affected areas.…”

Section: Discussionmentioning

confidence: 99%

Central Pontine Myelinolysis in Patients With Inadvertent Intravenous Fluid Therapy: A Case Report Series

Gimhavanekar¹,

Dahiphale²,

Kaginalkar³

et al. 2016

jemds

View full text Add to dashboard Cite

Central pontine myelinolysis is an acquired demyelinating disease. It is commonly associated with chronic alcoholics, electrolyte imbalance and chronically debilitated patients. It has predilection for involvement of central portion of basis pontis; however, it may involve axons in the putamina, caudate nuclei, thalami, cerebellum, splenium of the corpus callosum and subcortical white matter. [1] The term "osmotic demyelination syndrome" is similar to "central pontine myelinolysis," but also includes areas outside the pons. [2] It is characterised by loss of myelin and oligodendroglia with relative neuron sparing.

show abstract

Section: Discussionmentioning

confidence: 99%

Central Pontine Myelinolysis in Patients With Inadvertent Intravenous Fluid Therapy: A Case Report Series

Gimhavanekar¹,

Dahiphale²,

Kaginalkar³

et al. 2016

jemds

View full text Add to dashboard Cite

show abstract

“…A recuperação pode ser espontânea e progressiva, às vezes sem seqüelas neurológicas 1,5,6,12 . Parece não haver correlação entre as manifestações clínicas e a persistência das lesões nos exames de neuroimagem 7,10,14 , assim como entre a extensão da lesão na RM e a gravidade clínica da apresentação ou da evolução clínica subseqüente 12,14 . As anormalidades radiológicas podem estar presentes apesar de evidente melhora clínica ou após a resolução dos sintomas clínicos ou, do contrário, podem resolver-se a despeito dos achados clínicos neurológi-cos 7,12,14 .…”

Section: Discussionunclassified

“…Alguns autores utilizaram esteróides no tratamento da MPC, mas os resultados foram conflitantes 5,14 .…”

Section: Discussionunclassified

“…Sua apresentação clínica inclui tetraparesia inicialmente flácida e depois espástica, paralisia pseudobulbar, alterações agudas no estado mental com depressão da consciên-cia, coma, síndrome de encarceramento, podendo progredir para morte [1][2][3][4][5][6][7][8][9][10][12][13][14] . Comumente surge 2 a 7 dias após a correção da hiponatremia 2,3,5,9,12 .…”

Section: Introductionunclassified

“…Comumente surge 2 a 7 dias após a correção da hiponatremia 2,3,5,9,12 . A ataxia 5,7,12 é um sintoma incomum na MPC 14 . Descreveram-se distúrbios dos movimentos 3,5,6,12 , como mutismo, parkinsonismo, distonia, catatonia, entre outros.…”

Section: Introductionunclassified

See 2 more Smart Citations

Central pontine and extrapontine myelinolysis: report of a case with a tragic outcome

et al. 2006

View full text Add to dashboard Cite

Objective: To report a pediatric case of central pontine and extrapontine myelinolysis, a rare neurological disease often associated with rapid correction of hyponatremia.Description: A 15 year-old female adolescent developed lockedin syndrome during severe hyponatremia. Brain magnetic resonance imaging was consistent with the diagnosis of central pontine and extrapontine myelinolysis.Comments: Serum sodium correction should proceed slowly and cautiously, based upon a careful calculation of sodium deficit, in order to minimize metabolic stress and avoid the occurrence of this dreadful complication, which has a tragic outcome in most cases. There is no scientifically proved effective treatment for myelinolysis, and severe cases usually have a dismal prognosis. J Pediatr (Rio J) IntroduçãoA mielinólise pontina central (MPC) é uma doença desmielinizante aguda causada por oscilações abruptas na osmolalidade sérica, resultando em desmielinização simé-trica da parte central da base da ponte 1-3 . Ocorre esporadicamente em todas as idades 3-5 , acomete os dois sexos igualmente e sua incidência exata é desconhecida 4 .As lesões pontinas podem estar associadas à mielinólise extrapontina (MEP), a qual pode acometer de maneira simétrica os pedúnculos cerebelares, núcleo caudado, putame, substância branca frontal e temporal, fórnix, cápsula externa e extrema, claustro, tálamo, núcleo subtalâmico, cápsula interna, núcleo amigdalóide, corpo geniculado lateral, camadas profundas do córtex cerebral, hipocampo e corpo caloso 3,4,[6][7][8][9] .A patogenia ainda não foi totalmente esclarecida 1,2,5,9,10 , mas em geral está associada a perturbações eletrolíticas, particularmente hiponatremia profunda e sua rápida correção 2,3,5,[11][12][13] . Alguns distúrbios parecem acarretar predisposição ao desenvolvimento dessa complicação, como insuficiência hepática, transplante hepático, cirurgia de ressecção de tumor da hipófise, queimaduras graves, insuficiência renal crônica, hemodiálise, linfoma, carcinoma, desnutrição, infecções bacterianas graves, desidratação, desequilí-

show abstract

Osmotic Demyelination and Hypertonic Dehydration in a 9-Year-Old Girl: Changes in Cerebrospinal Fluid Myelin Basic Protein

Shah

Tobias

2006

J Intensive Care Med

View full text Add to dashboard Cite

A 9-year-old girl was admitted for the treatment of hyper-natremic dehydration. Her history was significant for psychogenic polydipsia, hyponatremia, and a renal concentrating defect. She presented with a 2-day history of altered mental status, ataxia, lethargy, fever, nausea, vomiting, and diarrhea. Meningitis was ruled out. Over the course of her illness, slow rehydration was maintained with a gradual decrease (10 mEq per 24 hours) of the serum sodium. Despite this care, she developed quadriparesis, and magnetic resonance imaging performed on day 6 of her illness was consistent with osmotic demyelination (central pontine myelinolysis). To rule out an excessively rapid correction of hypernatremia as the etiology of the problem, a myelin basic protein was measured in the cerebrospinal fluid that had been obtained on hospital day 1. The myelin basic protein was 649.50 ng/mL (normal, 0.07-4.10 ng/mL). The current literature is presented regarding the postulated pathogenesis of central pontine myelinolysis and suggested therapies, previous reports of central pontine myelinolysis in children are reviewed, and the potential role of myelin basic protein in its diagnosis is discussed.

show abstract

Idiopathic central pontine myelinolysis in childhood

Cited by 4 publications

References 21 publications

Central Pontine Myelinolysis in Patients With Inadvertent Intravenous Fluid Therapy: A Case Report Series

Central Pontine Myelinolysis in Patients With Inadvertent Intravenous Fluid Therapy: A Case Report Series

Central pontine and extrapontine myelinolysis: report of a case with a tragic outcome

Osmotic Demyelination and Hypertonic Dehydration in a 9-Year-Old Girl: Changes in Cerebrospinal Fluid Myelin Basic Protein

Contact Info

Product

Resources

About