Ocular Motor and Imaging Abnormalities of Midbrain Dysfunction in Osmotic Demyelination Syndrome

Hawthorne, Kristen M.; Compton, Christopher J.; Vaphiades, Michael S.; Roberson, Glenn H.; Kline, Lanning B.

doi:10.1097/wno.0b013e3181c25390

Cited by 12 publications

(3 citation statements)

References 19 publications

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“…Severe cases may present as “locked-in” syndrome or death. 6,7 The first 2 symptoms are most frequently encountered symptoms and were also found in our case.…”

Section: Discussionsupporting

confidence: 81%

Therapeutic Effect of Steroids in Osmotic Demyelination of Infancy

Bansal

2018

Child Neurology Open

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An 11-month-old male presented with acute gastroenteritis, seizures, and altered mental status. Laboratory workup revealed serum sodium of 177 mmol/L. Magnetic resonance imaging of the brain showed reduced diffusion in the supratentorial white matter, T2 hyperintensities in the left central pons and midbrain, subacute stroke in the right occipital lobe, and bilateral cerebellar hemorrhagic infarcts. The child was presumed to have hypernatremia-induced central pontine and extrapontine myelinolysis. He received 5 days of high-dose methylprednisolone for persistent encephalopathy and spastic quadriparesis with rapid recovery of his cognitive function and neurological examination. The child remained seizure-free and achieved normal development at 3-month and 2-year follow-ups. Osmotic demyelination of infancy may leave children with a significant neurological deficit. For favorable neurological outcome, early steroids should be considered.

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“…Severe cases may present as “locked-in” syndrome or death. 6,7 The first 2 symptoms are most frequently encountered symptoms and were also found in our case.…”

Section: Discussionsupporting

confidence: 81%

Therapeutic Effect of Steroids in Osmotic Demyelination of Infancy

Bansal

2018

Child Neurology Open

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“…We found 54 cases (63% female, median age 45 years, interquartile range 45-58 years) of osmotic demyelination syndrome published since 1997: 45 individual case reports and three case series including a total of nine patients (72,129,130,131,132,133,134,135,136,137,138,139,140,141,142,143,144,145,146,147,148,149,150,151,152,153,154,155,156,157,158,159,160,161,162,163,164,165,166,167,168,169,170,171,172,173,174,175). In 96% (52/54), the diagnosis of osmotic demyelination syndrome was based on magnetic...…”

Section: European Journal Of Endocrinologymentioning

confidence: 99%

Clinical practice guideline on diagnosis and treatment of hyponatraemia

Spasovski

Vanholder

Allolio

et al. 2014

European Journal of Endocrinology

631

671

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Hyponatraemia, defined as a serum sodium concentration !135 mmol/l, is the most common disorder of body fluid and electrolyte balance encountered in clinical practice. It can lead to a wide spectrum of clinical symptoms, from subtle to severe or even life threatening, and is associated with increased mortality, morbidity and length of hospital stay in patients presenting with a range of conditions. Despite this, the management of patients remains problematic. The prevalence of hyponatraemia in widely different conditions and the fact that hyponatraemia is managed by clinicians with a broad variety of backgrounds have fostered diverse institution-and speciality-based approaches to diagnosis and treatment. To obtain a common and holistic view, the European Society of Intensive Care Medicine (ESICM), the European Society of Endocrinology (ESE) and the European Renal Association -European Dialysis and Transplant Association (ERA-EDTA), represented by European Renal Best Practice (ERBP), have developed the Clinical Practice Guideline on the diagnostic approach and treatment of hyponatraemia as a joint venture of three societies representing specialists with a natural interest in hyponatraemia. In addition to a rigorous approach to methodology and evaluation, we were keen to ensure that the document focused on patient-important outcomes and included utility for clinicians involved in everyday practice.

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“…We agree that thiamine plays a role in carbohydrate metabolism and the administration of glucose and other carbohydrates without thiamine can be dangerous for patients with thiamine deficiency, while extrapontine myelinolysis (EPM) due to rapid correction of severe hyponatremia should also be taken into account since the patient manifested diplopia, weakness in both upper and lower extremities, urinary incontinence, and memory loss to recent events after she was admitted by the authors [3].…”

mentioning

confidence: 96%

Comments on “Wernicke’s Encephalopathy after Laparoscopic Roux-en-Y Gastric Bypass: A Misdiagnosed Complication”

Zhang

et al. 2010

OBES SURG

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Ocular Motor and Imaging Abnormalities of Midbrain Dysfunction in Osmotic Demyelination Syndrome

Cited by 12 publications

References 19 publications

Therapeutic Effect of Steroids in Osmotic Demyelination of Infancy

Therapeutic Effect of Steroids in Osmotic Demyelination of Infancy

Clinical practice guideline on diagnosis and treatment of hyponatraemia

Comments on “Wernicke’s Encephalopathy after Laparoscopic Roux-en-Y Gastric Bypass: A Misdiagnosed Complication”

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