Is osmotic demyelination syndrome reversible?

Is osmotic demyelination syndrome reversible?

The symptoms are often irreversible or only partially reversible, and they include dysarthria, dysphagia, tetraparesis, behavioral disturbances, lethargy, confusion, disorientation, and coma (2). When CPM develops after the rapid correction of hyponatremia, plasma exchange (PE) may be a beneficial therapy.

What is Extrapontine Myelinolysis?

Extrapontine myelinolysis (EPM) is one of the complications occurring secondary to rapid correction of hyponatremia, and is, along with central pontine myelinolysis encompassed by the more recent term osmotic demyelination syndrome.

Is osmotic demyelination syndrome permanent?

The disorder can resolve completely or result in permanent disability or death. This typical clinical course has been called the osmotic demyelination syndrome (ODS).

How long does osmotic demyelination syndrome last?

Symptoms of osmotic demyelination (eg, dysarthria, dysphagia, seizures, altered mental status, quadriparesis, hypotension) typically begin 1-5 days after correction of serum sodium level. The condition is typically irreversible and often devastating.

Can osmotic demyelination be cured?

ODS is an emergency disorder that needs to be treated in the hospital though most people with this condition are already in the hospital for another problem. There is no known cure for central pontine myelinolysis. Treatment is focused on relieving symptoms.

How common is osmotic demyelination?

[9] Though, the exact incidence of ODS is not known, an autopsy based study documented a prevalence rate of 0.25–0.5% in the general population[7] and 10% in patients undergoing liver transplantation.

How is osmotic demyelination treated?

Plasmapheresis can be considered as an effective treatment modality in chronic osmotic demyelination syndrome.

What are symptoms of demyelinating disease?

MS and other demyelinating diseases most commonly result in vision loss, muscle weakness, muscle stiffness and spasms, loss of coordination, change in sensation, pain, and changes in bladder and bowel function.

What do you need to know about osmotic demyelination syndrome?

Osmotic demyelination syndrome refers to acute demyelination seen in the setting of osmotic changes, typically with the rapid correction of hyponatremia. It is the more recent term replacing central pontine myelinolysis, recognizing that extrapontine structures can also be affected, previously known as extrapontine myelinolysis.

Is there such a thing as central pontine myelinolysis?

Central pontine myelinolysis (CPM) is now more commonly referred to as osmotic demyelination syndrome, which recognizes that the same phenomenon is also seen in other areas of the brain (previously known as extrapontine myelinolysis ). As such the condition is described in the osmotic demyelination syndrome article. Loading more images…

Can a liver transplant cause osmotic demyelination?

The possibility of EPM accounting for a proportion of the “acute encephalopathy”, the largest neurological complication following liver transplantation, does not appear to have been investigated. Osmotic demyelination, however, does not seem to occur with anything like the frequency one would expect in renal dialysis.

What does myelin stain show in basis pontis?

Pons with myelin stain (Luxol fast blue) showing lesion in basis pontis (CPM). Different case from gross specimen in fig 1. Microscopically the lesion shows degeneration and loss of oligodendrocytes with preservation of axons unless the lesion is very advanced.