Feb 16, 2017
In 1959, Adams and colleagues described a few patients who developed a rapid flaccid quadriparesis following fluid resuscitation for malnutrition and chronic alcoholism. Twenty years later, we learned that this occurs as a consequence of rapid correction of hyponatremia. But this isn't the only cause of the osmotic demyelination syndrome... Hear Dr. Joshua VanDerWerf discuss the history and clinical relevance of this unusual critical care scenario. BrainWaves podcasts and online content are intended for medical education only and should not be used to guide medical decision making in routine clinical practice. REFERENCES 1. Adams RA, Victor M, Mancall EL. Central pontine myelinolysis: a hitherto undescribed disease occurring in alcoholics and malnourished patients. Arch Neurol Psychiatry 1959;81:154–72. 2. Gocht A, Colmant HJ. Central pontine and extrapontine myelinolysis: a report of 58 cases. Clin Neuropathol. 1987 Nov-Dec;6(6):262-70. 3. Kleinschmidt-Demasters BK, Rojiani AM, Filley CM. Central and extrapontine myelinolysis: then...and now. J Neuropathol Exp Neurol. 2006 Jan;65(1):1-11. 4. Martin RJ. Central pontine and extrapontine myelinolysis: the osmotic demyelination syndromes. J Neurol Neurosurg Psychiatry. 2004;75 Suppl 3:iii22-8. 5. Menger H, Jorg J. Outcome of central pontine and extrapontine myelinolysis. J Neurol 1999;246:700–5. 6. Siegler JE, Wang AR, Vanderwerf JD. Normonatremic osmotic demyelination in the setting of acquired immune deficiency syndrome and malnutrition: case report and literature review. J Neurovirol. 2016 Jul 12. 7. Wright DG, Laureno R, Victor M. Pontine and extrapontine myelinolysis. Brain. 1979 Jun;102(2):361-85.