Central pontine myelinolysis

Case contributed by Augusto César Vieira Teixeira , 22 May 2013
Diagnosis probable
Changed by Henry Knipe, 16 Sep 2015

Updates to Case Attributes

Race changed from Other to .
Diagnostic Certainty was set to .
Presentation was changed:
A 35-year-old with suddenSudden onset of mental confusion and seizures during his admission due a adynamic ileus.
Body was changed:

Central pontine myelinolysis" was (CPM) was first termed in 1959 by Adams to describe a symmetric, demyelinating focus prominent in the central pons.The original patient population included only chronic alcoholics.This condition, however, has also been found in the malnourished, transplant recipients, or chronically debilitated patients,in particular, those in whom electrolyte abnormalities include hyponatremia that is rapidly over-corrected. Symptoms

Symptoms of CPM include tetraplegia, pseudobulbar palsy, and acute changes in mental status leading to coma or death without intervention. Similar histologic symmetric lesions were later identified in extrapontine locations, including the white matter of the cerebellum, thalamus, globus pallidus, putamen, and lateral geniculate body, a condition termed “extrapontineextrapontine myelinolysis

Today, the term osmotic demyelination syndrome is preferred to reflect both pontine and extrapontine involvement. 

  • -<p>"<a title="Central pontine myelinolysis (CPM)" href="/articles/central-pontine-myelinolysis">Central pontine myelinolysis</a>" was first termed in 1959 by Adams to describe a symmetric, demyelinating focus prominent in the central pons.The original patient population included only chronic alcoholics.This condition, however, has also been found in the malnourished, transplant recipients, or chronically debilitated patients,in particular, those in whom electrolyte abnormalities include hyponatremia that is rapidly over-corrected. Symptoms of CPM include tetraplegia, pseudobulbar palsy, and acute changes in mental status leading to coma or death without intervention. Similar histologic symmetric lesions were later identified in extrapontine locations, including the white matter of the cerebellum, thalamus, globus pallidus, putamen, and lateral geniculate body, a condition termed “extrapontine myelinolysis”</p>
  • +<p><a href="/articles/osmotic-demyelination-syndrome">Central pontine myelinolysis</a> (CPM) was first termed in 1959 by Adams to describe a symmetric, demyelinating focus prominent in the central pons.The original patient population included only chronic alcoholics.This condition, however, has also been found in the malnourished, transplant recipients, or chronically debilitated patients,in particular, those in whom electrolyte abnormalities include hyponatremia that is rapidly over-corrected. </p><p>Symptoms of CPM include tetraplegia, <a title="Pseudobulbar palsy" href="/articles/pseudobulbar-palsy">pseudobulbar palsy</a>, and acute changes in mental status leading to coma or death without intervention. Similar histologic symmetric lesions were later identified in extrapontine locations, including the white matter of the cerebellum, thalamus, globus pallidus, putamen, and lateral geniculate body, a condition termed <a title="Extrapontine myelinolysis (EPM)" href="/articles/extrapontine-myelinolysis-1">extrapontine myelinolysis</a>. </p><p>Today, the term <a title="Osmotic demyelination syndrome" href="/articles/osmotic-demyelination-syndrome">osmotic demyelination syndrome</a> is preferred to reflect both pontine and extrapontine involvement. </p>

Updates to Study Attributes

Findings was changed:

A symmetric  andand well-delimited lesion is seen located at the central portion of the pons withhypersignal high signal onT2-weighted T2 weighted images and hyposignal onlow signal on T1 images. This lesion spares the peripheral fibers.

Images Changes:

Image MRI (FLAIR) ( update )

Perspective was set to Axial.

Image MRI (T2) ( update )

Perspective was set to Axial.

Image MRI (T1) ( update )

Perspective was set to Sagittal.

Image 1 MRI (T1) ( update )

Position was set to .

Image 2 MRI (FLAIR) ( update )

Position was set to .

Image 3 MRI (T2) ( update )

Position was set to .

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