Central Pontine Myelinolysis

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Australasian Journal of Neuroscience

Australian Association of Neuroscience Nursing

Subject: Nursing

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ISSN: 1032-335X
eISSN: 2208-6781

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VOLUME 25 , ISSUE 1 (May 2015) > List of articles

Central Pontine Myelinolysis

Leigh Arrowsmith / Christopher Tolar

Keywords : Central pontine myelinolysis, myelin, pons, hyponatraemia

Citation Information : Australasian Journal of Neuroscience. Volume 25, Issue 1, Pages 15-19, DOI: https://doi.org/10.21307/ajon-2017-108

License : (CC BY-NC-ND 4.0)

Published Online: 10-January-2018

ARTICLE

ABSTRACT

Central Pontine Myelinolysis (CPM) commonly presents as a complication of treatment in patients with profound life threatening hyponatraemia. It occurs when the sodium level is corrected too rapidly. Hyponatraemia should never be corrected at a rate greater than 8-10mmol/L of sodium per day. Rapid correction causes extracellular tonicity and will continue to drive water out of the brain’s cells leading to cellular dysfunction.


Frequent clinical signs include dysphagia, dysarthria, diplopia and acute para/quadraparesis. Patients can also experience locked in syndrome, where cognitive function is intact but all muscles are paralysed with the exception of eye blinking.

CPM gets its name as it occurs when cell dysfunction causes destruction of the myelin sheath of nerve cells in the brain stem, more specifically the pons. It is associated with poor prognosis and prevention is of primary importance.


Freddy is a 35 year old freelance graphic designer, fitness instructor and ultra-marathon runner. In October 2011 he competed in the Sahara Marathon in Morocco, a 6 day 255km ultra-marathon. At the end of the third day Freddy was found collapsed and vomiting. He was confused and was suffering severe leg cramps. The next morning Freddy suffered a single convulsive episode and was subsequently transferred to a hospital in Egypt.

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REFERENCES

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