Spectrum of pathological changes observed in Osmotic Demyelination syndrome includes Central pontine myelinolysis
and extra-pontine myelinolysis
, which can be reported on computed tomography.
It is possible that our patient developed these neurologic sequalae due to combination of prolonged cerebral edema and central pontine myelinolysis
. It is unclear if our patient developed these complications due to severity of illness, therapies administered, or a combination of these elements.
Evolution of pontine and extrapontine myelinolysis
: Clinical correlation with serial CT and MRI studies.
caused by electrolyte imbalance during the management of suprasellar germ cell tumors: report of two cases.
While skeleton, neck, chest, abdomen, and pelvis scans showed no abnormal uptake of the tracer (data not shown), PET scan revealed abnormal hypermetabolic activity in the pons, suggestive of possible central pontine myelinolysis
at age 3 due to poor absorption of intranasal DDAVP Author Number of Number of hypona-tremia hyperna-tremia episodes episodes Rivkees 0 1 episode et al., 5 infants Abraham 0 0 et al.
[7,8] One is hyponatremic encephalopathy, and another is central pontine myelinolysis
. The mortality risk increases with the severity of hyponatremia (27% when serum sodium is < 120 mEq/L).
The osmotic demyelinating syndrome, formerly called central pontine myelinolysis
(because of the frequent pontine involvement) or extrapontine myelinolysis
(when other than pontine lesions are present), can be seen with any kind of osmotic gradient changes.
There have been a number of studies or single case descriptions reporting on isolated episodes of hypoglycaemic coma and on multiple cases of extrapontine and central pontine myelinolysis
with encephalopathy and coma in children with Addison disease [41-43].
Indications for conversion were peripheral neuropathy, seizure, metabolic encephalopathy, and central pontine myelinolysis
. All patients showed improvement or resolution of their neurological symptoms .
Thus, this patient group is at particularly high risk for the serious and often deadly sequelae of central pontine myelinolysis
In contrast, clinical manifestations that primarily present as the coexistence of distal renal tubular acidosis and central pontine myelinolysis
(CPM) are very rare in pSS.