eMedicine Specialties > Neurology > Neurotoxicology
Central Pontine Myelinolysis: Treatment & Medication
Updated: Aug 26, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Treatment
Medical Care
Treatment is supportive only.
- Correct hyponatremia at a rate of 10 µmol/L/24 h; diligently avoid hypernatremia. Details concerning the etiology and correction of electrolyte disorders are discussed extensively in general medicine texts.
- Alcoholic patients should receive vitamin supplementation. Formally evaluate their nutritional status.
Consultations
- Patients who survive central pontine myelinolysis likely require extensive and prolonged neurorehabilitation.
- Incorporate occupational, physical, speech, and language therapists early in the care of such patients.
- Swallowing studies are necessary to evaluate for dysphagia and determine the risk for aspiration pneumonia.
Diet
See Consultations.
Activity
See Consultations.
More on Central Pontine Myelinolysis |
| Overview: Central Pontine Myelinolysis |
| Differential Diagnoses & Workup: Central Pontine Myelinolysis |
Treatment & Medication: Central Pontine Myelinolysis |
| Follow-up: Central Pontine Myelinolysis |
| Multimedia: Central Pontine Myelinolysis |
| References |
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References
Adams RD, Victor M, Mancall EL. Central pontine myelinolysis: a hitherto undescribed disease occurring in alcoholic and malnourished patients. AMA Arch Neurol Psychiatry. Feb 1959;81(2):154-72. [Medline].
Singh N, Yu VL, Gayowski T. Central nervous system lesions in adult liver transplant recipients: clinical review with implications for management. Medicine (Baltimore). Mar 1994;73(2):110-8. [Medline].
DeWitt LD, Buonanno FS, Kistler JP, et al. Central pontine myelinolysis: demonstration by nuclear magnetic resonance. Neurology. May 1984;34(5):570-6. [Medline].
Haspolat S, Duman O, Senol U, Yegin O. Extrapontine myelinolysis in infancy: report of a case. J Child Neurol. Nov 2004;19(11):913-5. [Medline].
Karp BI, Laureno R. Pontine and extrapontine myelinolysis: a neurologic disorder following rapid correction of hyponatremia. Medicine (Baltimore). Nov 1993;72(6):359-73. [Medline].
Laureno R, Karp BI. Myelinolysis after correction of hyponatremia. Ann Intern Med. Jan 1 1997;126(1):57-62. [Medline].
Martin RJ. Central pontine and extrapontine myelinolysis: the osmotic demyelination syndromes. J Neurol Neurosurg Psychiatry. Sep 2004;75 Suppl 3:iii22-8. [Medline].
Further Reading
Keywords
central pontine myelinolysis, osmotic myelinolysis, CPM, hyponatremia, noninflammatory demyelination, stripping of the myelin sheath, alcoholism, liver disease, malnutrition
Treatment & Medication: Central Pontine Myelinolysis