Pontine and extrapontine myelinolysis associated with rapid correction of hyponatremia - a review
Pontine myelinolysis was first described in 1959 by Adams, Victor and Mancall and reported in alcoholic patients.[1] It is characterized, above all, by acute non-inflammatory symmetrical lesion of myelin sheath and apoptosis of oligodendrocytes affecting the central part of the basis pontis.[5] De...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Kazimierz Wielki University
2023-06-01
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| Series: | Journal of Education, Health and Sport |
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| Online Access: | https://apcz.umk.pl/JEHS/article/view/44076 |
| _version_ | 1797786992981835776 |
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| author | Hanna Dominik Wojciech Pawęska Jan Radwański Zuzanna Czudy Marika Polatowska Anna Gadomska Justyna Kurek Rafał Gorzyński Michał Garstka Justyna Molczyk-Sieńczak |
| author_facet | Hanna Dominik Wojciech Pawęska Jan Radwański Zuzanna Czudy Marika Polatowska Anna Gadomska Justyna Kurek Rafał Gorzyński Michał Garstka Justyna Molczyk-Sieńczak |
| author_sort | Hanna Dominik |
| collection | DOAJ |
| description | Pontine myelinolysis was first described in 1959 by Adams, Victor and Mancall and reported in alcoholic patients.[1] It is characterized, above all, by acute non-inflammatory symmetrical lesion of myelin sheath and apoptosis of oligodendrocytes affecting the central part of the
basis pontis.[5]
Demyelination may also appear in other parts of central nervous system such as thalamus, basal nuclei and cerebellum. Involvement of the regions beyond pons is called extrapontine myelinolysis. These two manifestations- pontine and extrapontine myelinolysis are combined in one neurological entity- osmotic demyelination syndrome.
Pontine and extrapontine myelinolysis are mainly caused by rapid increase in extracellular fluid osmolarity; usually in situation of iatrogenic correction of chronic hyponatremia.[7]
The other causes include severe electrolyte disturbances other than hyponatremia (hypokalemia, hypophosphatemia, hypernatremia), anorexia nervosa, AIDS, acute alcoholic hepatitis, liver transplantation, Vernickes syndrome, chemotherapy, chronic renal failure. [11,12] Osmotic demyelination syndrome vary in clinical manifestations. The most common presentations include encephalopathies, pareses, dystonias. The method of choice in diagnostic process is MRI imaging. Treatment of osmotic demyelination syndrome is still in an experimental phase. |
| first_indexed | 2024-03-13T01:15:41Z |
| format | Article |
| id | doaj.art-821f75f7dbfd4222aee5c656cc0c1e4d |
| institution | Directory Open Access Journal |
| issn | 2391-8306 |
| language | English |
| last_indexed | 2024-03-13T01:15:41Z |
| publishDate | 2023-06-01 |
| publisher | Kazimierz Wielki University |
| record_format | Article |
| series | Journal of Education, Health and Sport |
| spelling | doaj.art-821f75f7dbfd4222aee5c656cc0c1e4d2023-07-05T10:47:09ZengKazimierz Wielki UniversityJournal of Education, Health and Sport2391-83062023-06-0140110.12775/JEHS.2023.40.01.006Pontine and extrapontine myelinolysis associated with rapid correction of hyponatremia - a reviewHanna Dominik0Wojciech Pawęska1Jan Radwański2Zuzanna Czudy3Marika Polatowska4Anna Gadomska5Justyna Kurek6Rafał Gorzyński7Michał Garstka8Justyna Molczyk-Sieńczak9University Hospital, Zyty 26, 65-046 Zielona Gora, PolandSzpital Powiatowy im. bl. Marty Wieckiej w Bochni, ul. Krakowska 3, 32-700 Bochnia, PolandProvincial Specialist Hospital No. 4, Legionow 10, 41-902 Bytom, PolandUniversity Hospital, Collegium Medicum University of Zielona Gora, Zyty 28, 65-046 Zielona Gora, Poland, Collegium Medicum University of Zielona Gora, Zyty 28, Zielona Gora 65-046, PolandSzpital Uniwersytecki im. Karola Marcinkowskiego w Zielonej Górze, ul. Zyty 26, 65-046 Zielona Góra, PolandKliniczny Szpital Wojewódzki Nr 2 im. Św. Jadwigi Królowej w Rzeszowie, ul. Lwowska 60, 35-301 Rzeszów, PolandSzpital Kliniczny Przemienienia Pańskiego Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu, ul. Długa ½, 61-848 Poznań, PolandCentrum Medyczne HCP w Poznaniu, ul. 28 Czerwca 1956 r. 194, 61-485 Poznań, PolandNiepubliczny Zakład Opieki Zdrowotnej Alicja Ulanecka Stomatologia i Chirurgia stomatologiczna w Tarnowie, ul. Mościckiego 14, 33-100 Tarnów, PolandPontine myelinolysis was first described in 1959 by Adams, Victor and Mancall and reported in alcoholic patients.[1] It is characterized, above all, by acute non-inflammatory symmetrical lesion of myelin sheath and apoptosis of oligodendrocytes affecting the central part of the basis pontis.[5] Demyelination may also appear in other parts of central nervous system such as thalamus, basal nuclei and cerebellum. Involvement of the regions beyond pons is called extrapontine myelinolysis. These two manifestations- pontine and extrapontine myelinolysis are combined in one neurological entity- osmotic demyelination syndrome. Pontine and extrapontine myelinolysis are mainly caused by rapid increase in extracellular fluid osmolarity; usually in situation of iatrogenic correction of chronic hyponatremia.[7] The other causes include severe electrolyte disturbances other than hyponatremia (hypokalemia, hypophosphatemia, hypernatremia), anorexia nervosa, AIDS, acute alcoholic hepatitis, liver transplantation, Vernickes syndrome, chemotherapy, chronic renal failure. [11,12] Osmotic demyelination syndrome vary in clinical manifestations. The most common presentations include encephalopathies, pareses, dystonias. The method of choice in diagnostic process is MRI imaging. Treatment of osmotic demyelination syndrome is still in an experimental phase. https://apcz.umk.pl/JEHS/article/view/44076osmotic demyelination syndromeextrapontine myelinolysispontine myelinolysishyponatremiarapid serum electrolyte correctionCNS lesions |
| spellingShingle | Hanna Dominik Wojciech Pawęska Jan Radwański Zuzanna Czudy Marika Polatowska Anna Gadomska Justyna Kurek Rafał Gorzyński Michał Garstka Justyna Molczyk-Sieńczak Pontine and extrapontine myelinolysis associated with rapid correction of hyponatremia - a review Journal of Education, Health and Sport osmotic demyelination syndrome extrapontine myelinolysis pontine myelinolysis hyponatremia rapid serum electrolyte correction CNS lesions |
| title | Pontine and extrapontine myelinolysis associated with rapid correction of hyponatremia - a review |
| title_full | Pontine and extrapontine myelinolysis associated with rapid correction of hyponatremia - a review |
| title_fullStr | Pontine and extrapontine myelinolysis associated with rapid correction of hyponatremia - a review |
| title_full_unstemmed | Pontine and extrapontine myelinolysis associated with rapid correction of hyponatremia - a review |
| title_short | Pontine and extrapontine myelinolysis associated with rapid correction of hyponatremia - a review |
| title_sort | pontine and extrapontine myelinolysis associated with rapid correction of hyponatremia a review |
| topic | osmotic demyelination syndrome extrapontine myelinolysis pontine myelinolysis hyponatremia rapid serum electrolyte correction CNS lesions |
| url | https://apcz.umk.pl/JEHS/article/view/44076 |
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