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Neurol Sci 2021 May 5. Epub 2021 May 5.

Department of Neurology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55902, USA.

Objectives: Central pontine myelinolysis (CPM) is a neurological disorder characterized by damage to the myelin and oligodendrocytes in the pons. This review focuses on the history of CPM and the discovery of its association with the treatment of hyponatremia.

Methods: The author reviewed original publications regarding CPM, hyponatremia, and the treatment of hyponatremia. Read More

Int J Mol Sci 2021 Apr 8;22(8). Epub 2021 Apr 8.

Institute of Neuropathology, University Hospital Essen, D-45147 Essen, Germany.

Quantifying O-methylguanine-DNA methyltransferase (MGMT) promoter methylation plays an essential role in assessing the potential efficacy of alkylating agents in the chemotherapy of malignant gliomas. MGMT promoter methylation is considered to be a characteristic of subgroups of certain malignancies but has also been described in various peripheral inflammatory diseases. However, MGMT promoter methylation levels have not yet been investigated in non-neoplastic brain diseases. Read More

Int J Neurosci 2021 Mar 25:1-6. Epub 2021 Mar 25.

Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México.

Osmotic demyelination syndrome (ODS) is a non-inflammatory process of the central nervous system caused by extracellular osmotic changes, which leads to oligodendrocyte apoptosis and disruption of myelin sheaths, usually affecting patients with underlying systemic conditions that impose susceptibility to osmotic stress. Description of ODS in patients with non-Hodgkin lymphoma (NHL) is limited to a few case reports. Here, we report a 44-year-old man with NHL that had an incidental diagnosis of ODS. Read More

Mol Genet Metab Rep 2021 Jun 13;27:100742. Epub 2021 Mar 13.

Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Adult-onset non-cirrhotic hyperammonemia (NCH) is a rare, but often fatal condition that can result in both reversible and irreversible neurological defects. Here we present five cases of adult-onset non-cirrhotic hyperammonemia wherein brain magnetic resonance spectroscopy (MRS) scans for cerebral glutamine (Gln) and myo-inositol (mI) levels helped guide clinical management. Specifically, we demonstrate that when combined with traditional brain magnetic resonance imaging (MRI) scans, cerebral Gln and mI MRS can help disentangle the reversible from irreversible neurological defects associated with hyperammonemic crisis. Read More

Medicine (Baltimore) 2021 Mar;100(10):e25075

Department of Radiology.

Rationale: Pituitary tumor apoplexy (PTA) is a rare clinical syndrome which requires urgent diagnosis and treatment due to its life-threatening consequences. Management of undiagnosed pituitary tumor before pregnancy is a problem during pregnancy.

Patient Concerns: We reported a case with PTA which was not diagnosed before pregnancy presenting with vomiting associated with hyponatremia during the third trimester. Read More

Acta Neurol Belg 2021 Mar 13. Epub 2021 Mar 13.

Department of Neurology, Auckland City Hospital, Auckland, New Zealand.

Central pontine myelinolysis and extrapontine myelinolysis are collectively called the osmotic demyelination syndromes. Despite being described in 1959, there are several aspects of the disorder that remain an enigma. Animal models and neuroimaging techniques have allowed us to understand the condition better. Read More

Acta Anaesthesiol Scand 2021 Feb 17. Epub 2021 Feb 17.

Kidney Center, Turku University Hospital and University of Turku, Turku, Finland.

Background: The safety of continuous veno-venous hemodialysis (CVVHD) with citrate-calcium anticoagulation for acute kidney injury (AKI) with coincident hyponatremia remains unclear. We aimed to explore the feasibility of CVVHD with standard dialysate and citrate-calcium anticoagulation in hyponatremic critically ill AKI patients.

Methods: Thirty-seven of the 493 critically ill AKI patients requiring CVVHD and admitted to our intensive care unit during a 10-year period had hyponatremia (<130 mmol/L) and were included in this retrospective study. Read More

Neuropathology 2021 Apr 20;41(2):127-132. Epub 2021 Jan 20.

Department of Psychiatry, Nagoya University, Nagoya, Japan.

Anorexia nervosa (AN) is a serious eating disorder characterized by self-starvation and extreme weight loss. It has the highest mortality rate among all psychiatric disorders. Recent research indicates that malnutrition in AN patients induces various kinds of functional brain damage, but the pathophysiology of AN remains unclear. Read More

Acta Neuropathol Commun 2020 12 24;8(1):224. Epub 2020 Dec 24.

Institute of Neuropathology, University Medical Center Göttingen, 37075, Göttingen, Germany.

Demyelinated lesions in human pons observed after osmotic shifts in serum have been referred to as central pontine myelinolysis (CPM). Astrocytic damage, which is prominent in neuroinflammatory diseases like neuromyelitis optica (NMO) and multiple sclerosis (MS), is considered the primary event during formation of CPM lesions. Although more data on the effects of astrocyte-derived factors on oligodendrocyte precursor cells (OPCs) and remyelination are emerging, still little is known about remyelination of lesions with primary astrocytic loss. Read More

Clin Diabetes Endocrinol 2020 Nov 16;6(1):23. Epub 2020 Nov 16.

Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.

Background: Central pontine myelinolysis (CPM) is a non-inflammatory demyelinating lesion of the pons. CPM and extrapontine demyelination (EPM) are together termed osmotic demyelination syndrome (ODS), a known and serious complication of acute correction of hyponatremia. Conversely, hyperglycemic hyperosmolarity syndrome (HHS) develops in patients with type 2 diabetes who still have some insulin secretory ability due to infection, non-compliance with treatment, drugs, and coexisting diseases, and is often accompanied by ketosis. Read More

Disabil Rehabil Assist Technol 2020 Dec 8:1-12. Epub 2020 Dec 8.

G.C.A.-Spoke Center, A.O. Cannizzaro Catania, IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy.

Background And Purpose: Central pontine myelinolysis (CPM) is a solitary, symmetric, demyelination in the central pons. This case study aimed to report the effects of an intensive robotic gait training with Lokomat-Pro on mobility and quality of life in a case of CPM.

Case Description And Intervention: A 33-year-old female patient with tetraparesis and gait disturbance due to CPM was hospitalized to undergo intensive rehabilitation training for about 2 months. Read More

Neuropsychiatr 2020 Dec 23;34(4):175-178. Epub 2020 Nov 23.

Klinik für Psychiatrie, Sozialpsychiatrie und Psychotherapie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.

Central pontine myelinolysis is a rare but severe disease that often occurs in alcohol-dependent and malnourished patients. One pathological mechanism is the rapid correction of chronic hyponatremia, even though the disease can occur independently of decreased serum sodium levels. Here, we present a patient suffering from malnutrition, alcohol dependency, and a severe depressive disorder, who presented himself to our clinic wishing for qualified withdrawal treatment. Read More

Rofo 2020 Nov 19. Epub 2020 Nov 19.

Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany.

Purpose:  To describe findings on cerebral imaging in patients with COVID-19 and neurological symptoms at two German university hospitals.

Materials And Methods:  Patients with COVID-19 and neurological symptoms and cerebral imaging (CT or MRI) were included. A chart review regarding neurological symptoms, COVID-19 and imaging findings was conducted. Read More

Front Endocrinol (Lausanne) 2020 14;11:548877. Epub 2020 Oct 14.

Department of Pediatrics II, Pediatric Nephrology, University Hospital Essen, University Duisburg-Essen, Duisburg, Germany.

Hashimoto's thyroiditis is frequently associated with other autoimmune diseases and may include renal involvement. A 17-year-old female with previously diagnosed Hashimoto's thyroiditis and vitiligo was admitted to a pediatric intensive care unit with hypokalemic paralysis and acidosis, after having suffered from recurrent muscular weakness for approximately one year. A few days later she developed central pontine myelinolysis. Read More

J Int Med Res 2020 Oct;48(10):300060520966494

Child Neuropsychiatry, Obstetric and Pediatric Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.

Bartter syndrome (BS) is a rare autosomal recessive renal tubular disorder characterized by acute electrolyte imbalance, and similarly, osmotic demyelination syndrome (ODS) is a rather rare complication occurring during electrolyte imbalance. The pathological features of ODS include central pontine myelinolysis and extrapontine myelinolysis (EPM), which consist of severe damage to the myelin sheath of neurons. ODS is very rare in children. Read More

Case Rep Nephrol 2020 7;2020:4079098. Epub 2020 Sep 7.

Hospital Renascentista, Pouso Alegre, MG, Brazil.

. Central pontine myelinolysis is characterized by the occurrence of acute demyelinating lesions of cells in the pons secondary to abrupt oscillations of serum osmolarity. Its exact incidence is not well defined, but studies show a prevalence of 0. Read More

Medicine (Baltimore) 2020 Sep;99(38):e22004

Department of Neurosurgery, Lishui Hospital, Zhejiang University School of Medicine.

Background: Mannitol and hypertonic saline (HTS) are effective in reducing intracranial pressure (ICP) after severe traumatic brain injury (TBI). However, their efficacy on the ICP has not been evaluated rigorously.

Objective: To evaluate the efficacy of repeated bolus dosing of HTS and mannitol in similar osmotic burdens to treat intracranial hypertension (ICH) in patients with severe TBI. Read More

J Int Med Res 2020 Jul;48(7):300060520943824

Emergency Department of Internal Medicine, the First Hospital of Jilin University, Changchun, Jilin, China.

Diquat is a nonselective herbicide that is used as a contact and preharvest desiccant to control terrestrial and aquatic vegetation. Increasing numbers of cases of diquat poisoning have recently been reported. Organs commonly affected by diquat poisoning include the kidney, liver, and lung. Read More

Kans J Med 2020 10;13:191-193. Epub 2020 Jul 10.

University of Kansas School of Medicine-Wichita, Department of Internal Medicine, Wichita, KS.

Am J Case Rep 2020 Jul 9;21:e923406. Epub 2020 Jul 9.

Department of Radiology, Chosun University Hospital, Gwangju, South Korea.

BACKGROUND Osmotic demyelination syndrome (ODS) is an uncommon neurological disorder. Until the mid-1980s, the mortality rate was 90-100%, but more than half of patients now have a good prognosis. Early suspicion of ODS is important. Read More

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2020 Jun;38(6):461-462

Department of Emergency, The First Hospital of Jilin University, Jilin 130021, China.

To analyze the clinical presentation and the treatment process of one case of colchicine poisoning complicated with extra pontine myelinolysis and discuss its pathogenesis. Increasing the attention of hyponatremia caused by colchicine poisoning is of great significance for improving the prognosis and quality of life of patients. Read More

Cureus 2020 May 20;12(5):e8209. Epub 2020 May 20.

Radiology, St. Barnabas Hospital Health System, Albert Einstein College of Medicine, Bronx, USA.

Acute demyelination of the pons or extrapontine areas results in an osmotic demyelination syndrome (ODS), previously referred to as central pontine myelinolysis (CPM) or extra pontine myelinolysis (EPM). It is caused by osmotic dysregulation in the brain. Multiple risk factors have been known to contribute to these osmotic disturbances. Read More

Ann Palliat Med 2021 Feb 25;10(2):2349-2353. Epub 2020 May 25.

Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Changchun, China.

Medulla oblongata myelinolysis is an extremely rare manifestation of extrapontine myelinolysis (EPM). Herein, we report a case of a 34-year-old man with a history of gout who presented repeated vomiting and diarrhea after ingesting 15 colchicine pills. A hyponatremia diagnosis was given and after an intensive treatment, his serum sodium level increased from 118 to 129 mmol/L within 24 hours. Read More

Childs Nerv Syst 2021 Mar 6;37(3):1025-1027. Epub 2020 Jun 6.

Department of Radiology, Adana City Education and Research Hospital, Adana, Turkey.

Osmotic demyelination syndrome (ODS) is a very rare condition in childhood occurring usually secondary to the rapid increase of serum sodium levels. This situation occurring secondary to the rapid correction of hyponatremia can be seen more rarely in the form of extrapontine myelinolysis and even the coexistence of these two conditions besides central pontine demyelinolysis. However, osmotic demyelination syndrome due to the rapid correction of hyponatremia in chronic renal failure (CRF) patients is very rare depending on existing uremia. Read More

Continuum (Minneap Minn) 2020 06;26(3):632-658

Purpose Of Review: This article provides an overview of the major electrolyte disorders and discusses in detail the homeostasis, etiologies, neurologic manifestations, and treatment of these disorders.

Recent Findings: The diagnosis and management of hyponatremia continue to evolve. Diagnostic accuracy is improved by assessing serum and urine osmolality as well as urinary sodium. Read More

World Neurosurg 2020 08 19;140:63-64. Epub 2020 May 19.

Institute of Neuroradiology, Cantonal Hospital, Aarau, Switzerland.

An elderly woman was transferred for biopsy of a pontine lesion. Her condition, including gait disturbances, truncal ataxia, and dysarthria-presumed to be due to severe alcohol abuse-had deteriorated during treatment of ambulatory-acquired pneumonia. No electrolyte abnormalities were noted during hospitalization. Read More

Mov Disord Clin Pract 2020 Apr 16;7(3):335-337. Epub 2020 Mar 16.

Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla Seville Spain.

Neurology 2020 04 27;94(16):e1780-e1781. Epub 2020 Mar 27.

From the Departments of Internal Medicine (P.P., S.B.) and Neurology (J.P.), Texas Tech University Health Science Center, Lubbock.

Pan Afr Med J 2019 20;34:208. Epub 2019 Dec 20.

Service d'Accueil des Urgences Vitales, Département d'Anesthésie Réanimation et Urgences, Hôpital Ibn Tofail, CHU Mohammed VI, Faculté de Médecine et de Pharmacie de Marrakech, Université Cadi Ayyad, Marrakech, Maroc.

Osmotic demyelination syndrome is characterized by the loss of myelin in the center of the basis pontis and other areas of the central nervous system. We report a case of osmotic demyelination syndrome in a 55-year-old female, with a past medical history of arterial hypertension and multi-level cervical spondylosis, hospitalized for acute altered mental status complicating an array of acute gastroenteritis, the patient was afebrile. The course was marked by neurologic aggravation with confusion, aphasia, tetraplegia and osteo-tendinous areflexia. Read More

Neurol India 2020 Jan-Feb;68(1):146-151

Department of Neurology, Faculty of Medicine, Cairo University, Giza, Egypt.

Background And Aim: Liver transplantation (LT) is the only curative treatment for patients with the end-stage liver disease. Amongst the complications post-LT, the neurological complications (NC) are particularly relevant. Our aim is to assess the incidence, risk factors and clinical presentation of NC in recipients after living donor liver transplantation. Read More