Psychiatric symptoms and limb tremors associated with central pontine myelinolysis: A case of alcoholism without hyponatremia

Feng, Xuebing; Zhao, Teng; Zhou, Chunkui; Liu, Jingyao

doi:10.3892/etm.2016.3780

Cited by 6 publications

(9 citation statements)

References 13 publications

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“…Clinical manifestations of CPM vary based on the brain region involved and typically include spastic quadriparesis, dysarthria, dysphagia, sensory alterations, and encephalopathy of various degrees as well as ‘locked-in syndrome’in severe cases [ 1 , 3 , 5 , 22 ]. Our patient developed a predominant clinical manifestation of ataxia along with mild dysphagia, caused by injury to corticocerebellar and corticobulbar fibres, respectively.…”

Section: Discussionmentioning

confidence: 99%

A rare presentation of central pontine myelinolysis secondary to hyperglycaemia

et al. 2023

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Background Central pontine myelinolysis (CPM) is a rare demyelinating disorder caused by the loss of myelin in the center of the basis pontis. CPM typically occurs with rapid correction of severe chronic hyponatremia and subsequent disturbances in serum osmolality. Although hyperglycaemia is recognized as a pathogenetic factor in serum osmolality fluctuations, CPM is rarely seen in the context of diabetes. Case presentation A 66-year-old Chinese male presented with a history of gait imbalance, mild slurred speech and dysphagia for two weeks. MRI showed the mass lesions in the brainstem, and laboratory examinations showed high blood glucose and HbA1c, as well as increased serum osmolality. The patient was diagnosed with CPM secondary to hyperosmolar hyperglyceamia and received insulin treatment as well as supportive therapy. After six weeks of followup, the patient had fully recovered to a normal state. Conclusion CPM is a potentially fatal neurological condition and can occur in uncontrolled diabetes mellitus. Early diagnosis and timely treatment are crucial for improving the prognosis.

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Section: Discussionmentioning

confidence: 99%

A rare presentation of central pontine myelinolysis secondary to hyperglycaemia

et al. 2023

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“…It is commonly seen that CPM has been linked with chronic underlying diseases such as alcoholism, diabetes, malnutrition, malignancy, and human immunodeficiency virus (HIV). Among the causes above, chronic alcoholism is the most common cause [ 3 ]. However, in our case, the patient had no underlying chronic illnesses and hyponatremia secondary to intractable vomiting, which was erroneously corrected rapidly, leading to osmotic demyelination in the central pons.…”

Section: Discussionmentioning

confidence: 99%

“…Two forms of ODS are known, one of which is CPM and the other is extra-pontine myelinolysis [ 2 ]. CPM is a rare, acute, non-inflammatory, demyelinating disorder characterized by loss of myelin sheath in the neurons of central pons [ 3 ]. Extra-pontine structures like the midbrain, thalamus, and cerebellum may also be involved [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Rapid Correction of Hyponatremia With Isotonic Saline Leading to Central Pontine Myelinolysis

Khan¹,

Das²,

Batool³

et al. 2023

Cureus

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Central pontine myelinolysis (CPM) is a part of the spectrum of osmotic demyelination syndrome (ODS), which is a rare demyelinating disorder due to the rapid correction of low serum sodium. It affects the neurons of the pons but may also involve other extra-pontine sites. The disease is characterized by a wide variety of clinical features ranging from dysarthria, dysphagia, bulbar palsy, quadriplegia, and behavioral and psychiatric disturbances. We present a case of a young female who developed CPM due to rapid sodium correction after vomiting. She presented with quadriplegia and locked-in syndrome. The diagnosis is on the basis of clinical and radiographic features. Magnetic resonance imaging (MRI) of the brain is superior to computed tomography (CT) in detecting changes. It shows hyperintensities on T2-weighted images that are classically known as the trident sign in the region of the pons. The patient was managed supportively, and the family was counseled regarding the poor prognosis of the disease. Unfortunately, she met a fatal fate due to a complication of CPM that is aspiration pneumonia. It is, therefore, imperative to create more awareness regarding the disease, and measures should be taken for its prevention that includes correction of low sodium levels not greater than 10 mmol/L/day.

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“…There are other case reports of patients developing CPM that are not related to profound hyponatremia or the rapid correction of hyponatremia. These case reports have found the cause to be associated with alcohol withdrawal, hypokalemia, anorexia nervosa when feeding is started, patients undergoing dialysis, and burns victims [5][6][7]. We present a case of CPM associated with alcohol abuse and acute pancreatitis without profound hyponatremia, or rapid correction of hyponatremia.…”

Section: Introductionmentioning

confidence: 99%

Alcohol and acute pancreatitis contributing to central pontine myelinolysis

Farrer¹

2018

Case Rep Int

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Introduction: Central pontine myelinolysis (CPM) is a well-recognized syndrome that is related to various conditions such as rapid correction of hyponatremia and chronic alcoholism. Case Report: We report a case of a recently discharged patient with dysarthria, vertigo, and progressive gait changes, with radiological evidence of CPM, but without the expected rapid correction of hyponatremia seen in other patients that developed CPM. Conclusion: CPM is rare without severe hyponatremia of 120 meq/L or less, but there are other factors that contribute to the development of CPM, that may be unrelated to hyponatremia. Severe alcohol abuse, acute pancreatitis, and subsequent poor nutritional intake were likely the major factors in inducing osmotic injury in this case, which lead to CPM.

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Psychiatric symptoms and limb tremors associated with central pontine myelinolysis: A case of alcoholism without hyponatremia

Cited by 6 publications

References 13 publications

A rare presentation of central pontine myelinolysis secondary to hyperglycaemia

A rare presentation of central pontine myelinolysis secondary to hyperglycaemia

Rapid Correction of Hyponatremia With Isotonic Saline Leading to Central Pontine Myelinolysis

Alcohol and acute pancreatitis contributing to central pontine myelinolysis

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