Central Pontine Myelinolysis

Excerpt

Central pontine myelinolysis (CPM) is a component of osmotic demyelination syndrome (ODS). It is characterized by damage to regions of the brain, most commonly pontine white matter tracts, after rapid correction of metabolic disturbances such as hyponatremia. Central pontine myelinolysis (CPM) was first described in 1959 by Adams and his colleagues in a report of four patients with pseudobulbar palsy and quadriplegia. The initial cases were seen in patients with alcohol use disorder and malnutrition; however, by the 1970s, subsequent cases showed a link with rapid sodium correction. CPM has since been reported in cases of severe burns, liver transplantation, anorexia nervosa and hyperemesis gravidarum, and hyperglycemic states. Clinical features of CPM typically begin to appear within several days after rapid correction of hyponatremia. Clinical manifestations vary and can range from encephalopathy to coma and death.