Subacute necrotizing encephalomyelopathy: Its relationship to central pontine myelinolysis

Faris, Amin A.; Fleckenstein, Loran D.

doi:10.1136/jnnp.33.5.667

Cited by 4 publications

(2 citation statements)

References 15 publications

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“…However, a number of cases have been reported in the literature suggesting the occurrence of demyelination in the absence of hyponatremia [7, 23, 24, 25]. …”

Section: Etiology and Pathogenesismentioning

confidence: 99%

Central Pontine Myelinolysis

Lampl

Yazdi²

2002

Eur Neurol

225

143

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Central pontine myelinolysis (CPM) is a demyelinating disease of the pons often associated with demyelination of other areas of the central nervous system (CNS). The term ‘osmotic demyelinization syndrome’ is used for pontine and extrapontine myelinolysis. In this paper, we are concerned with CPM although the extrapontine one is based on the same pathogenesis. Both share the diagnostic methods, and their prevention and therapy are the same. The etiology and pathogenesis of this disorder are unclear and will be discussed. However, almost all cases of CPM are related to severe diseases. Chronic alcoholism is still the most common underlying condition of CPM patients. In the literature, 174 cases of CPM have been reported in alcoholics since 1986, which is equivalent to an incidence of 39.4%. Likewise, 95 cases of CPM following the correction of hyponatremia have been documented since 1986 (21.5%). The role of hyponatremia and its correction will be outlined in the discussion of the pathogenesis of CPM. The third largest group of CPM cases are liver transplant patients (17.4%), with the development of CPM being attributed to the immunosuppressive agent cyclosporine in particular. Depending on the involvement of other CNS structures, the clinical picture can vary considerably. The large-scale introduction of magnetic resonance imaging has increasingly facilitated the antemortem diagnosis of CPM, although the radiological findings lag behind and do not necessarily correlate with the clinical picture. As yet, there is no specific therapy of choice. A number of therapeutic approaches have been tested and although they have not been compared with regard to their rate of success, they have all led to a substantial improvement in the prognosis of CPM.

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“…However, a number of cases have been reported in the literature suggesting the occurrence of demyelination in the absence of hyponatremia [7, 23, 24, 25]. …”

Section: Etiology and Pathogenesismentioning

confidence: 99%

Central Pontine Myelinolysis

Lampl

Yazdi²

2002

Eur Neurol

225

143

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“…Other encephalopathies have been compared to CPM. Although clinical features are similar in subacute necrotizing encephalomyelopathy (Leigh disease) the histology is different and anatomical involvement is wider (Faris and Fleckenstein 1970).…”

Section: Discussionmentioning

confidence: 99%

Idiopathic central pontine myelinolysis in childhood

Menakaya¹,

Wassmer²,

Bradshaw³

et al. 2001

Dev Med Child Neurol

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Central pontine myelinolysis (CPM) is rare in childhood with only a few cases reported in world literature. We report a 7-year-old male who presented with acute ataxia, swallowing difficulties, dysarthria, and radiological features consistent with the disorder. He improved remarkably with oral prednisolone therapy and was almost back to normal by 2 weeks. A review of the literature is also included.

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