Osmotic demyelination syndrome - Revision history

Michael: /* www */

2018-06-22T16:18:13Z

www

← Older revision		Revision as of 16:18, 22 June 2018
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	DDx:		DDx:
	*MS /ADEM.		*[[Multiple sclerosis\|MS]] /[[Acute disseminated encephalomyelitis\|ADEM]].
	*PACNS - Primary angiitis of the central nervous system.		*PACNS - Primary angiitis of the central nervous system.
	*CLIPPERS - Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids.		*CLIPPERS - Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids.


	==See also==		==See also==

Jensflorian: /* See also */

2018-06-22T10:13:07Z

Michael: /* General */

2017-10-19T13:31:04Z

General

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	*Quadriplegia.		*Quadriplegia.
	*Poor prognosis.		*Poor prognosis.
	*May cause ''locked-in syndrome'' - ~~in ability~~ to produce voluntary responses with preservation of intellectual ~~capcity~~.<ref name=pmid25379502>{{Cite journal \| last1 = Sohn \| first1 = MK. \| last2 = Nam \| first2 = JH. \| title = Locked-in Syndrome due to Central Pontine Myelinolysis: Case Report. \| journal = Ann Rehabil Med \| volume = 38 \| issue = 5 \| pages = 702-6 \| month = Oct \| year = 2014 \| doi = 10.5535/arm.2014.38.5.702 \| PMID = 25379502 }}</ref>		*May cause ''locked-in syndrome'' - inability to produce voluntary responses with preservation of intellectual capacity.<ref name=pmid25379502>{{Cite journal \| last1 = Sohn \| first1 = MK. \| last2 = Nam \| first2 = JH. \| title = Locked-in Syndrome due to Central Pontine Myelinolysis: Case Report. \| journal = Ann Rehabil Med \| volume = 38 \| issue = 5 \| pages = 702-6 \| month = Oct \| year = 2014 \| doi = 10.5535/arm.2014.38.5.702 \| PMID = 25379502 }}</ref>

	==Microscopic==		==Microscopic==

Michael: /* General */

2017-10-19T13:30:48Z

General

← Older revision		Revision as of 13:30, 19 October 2017
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	*Quadriplegia.		*Quadriplegia.
	*Poor prognosis.		*Poor prognosis.
			*May cause ''locked-in syndrome'' - in ability to produce voluntary responses with preservation of intellectual capcity.<ref name=pmid25379502>{{Cite journal \| last1 = Sohn \| first1 = MK. \| last2 = Nam \| first2 = JH. \| title = Locked-in Syndrome due to Central Pontine Myelinolysis: Case Report. \| journal = Ann Rehabil Med \| volume = 38 \| issue = 5 \| pages = 702-6 \| month = Oct \| year = 2014 \| doi = 10.5535/arm.2014.38.5.702 \| PMID = 25379502 }}</ref>

	==Microscopic==		==Microscopic==

Michael: /* General */

2017-08-18T15:00:07Z

General

← Older revision		Revision as of 15:00, 18 August 2017
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	==General==		==General==
	*Classically in the pons~~, ergo "pontine" is in the name~~.		*Classically in the pons.
	*Classically midline, ergo "central" is in the name.		*Classically midline, ergo "central" was previously in the name.
	**May occur elsewhere -~~- known~~ as ''extrapontine myelinolysis''.		**May occur elsewhere - previously referred to as ''extrapontine myelinolysis''.

	Etiology:		Etiology:

Michael at 14:59, 18 August 2017

2017-08-18T14:59:09Z

← Older revision		Revision as of 14:59, 18 August 2017
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	'''Osmotic demyelination syndrome''', abbreviated '''ODS''', is a demyelination associated with osmotic imbalances.		'''Osmotic demyelination syndrome''', abbreviated '''ODS''', is a demyelination associated with osmotic imbalances.

	It classically affect the [[pons]] and was previously known as '''central pontine myelinolysis'''.<ref name=pmid24745890>{{Cite journal \| last1 = Alleman \| first1 = AM. \| title = Osmotic demyelination syndrome: central pontine myelinolysis and extrapontine myelinolysis. \| journal = Semin Ultrasound CT MR \| volume = 35 \| issue = 2 \| pages = 153-9 \| month = Apr \| year = 2014 \| doi = 10.1053/j.sult.2013.09.009 \| PMID = 24745890 }}</ref>		It classically affect the pons and was previously known as '''central pontine myelinolysis'''.<ref name=pmid24745890>{{Cite journal \| last1 = Alleman \| first1 = AM. \| title = Osmotic demyelination syndrome: central pontine myelinolysis and extrapontine myelinolysis. \| journal = Semin Ultrasound CT MR \| volume = 35 \| issue = 2 \| pages = 153-9 \| month = Apr \| year = 2014 \| doi = 10.1053/j.sult.2013.09.009 \| PMID = 24745890 }}</ref> The name was changed as it is now recognized that it can occur extrapontine.<ref name=pmid26124552>{{Cite journal \| last1 = Zunga \| first1 = PM. \| last2 = Farooq \| first2 = O. \| last3 = Dar \| first3 = MI. \| last4 = Dar \| first4 = IH. \| last5 = Rashid \| first5 = S. \| last6 = Rather \| first6 = AQ. \| last7 = Basu \| first7 = JA. \| last8 = Ashraf \| first8 = M. \| last9 = Bhat \| first9 = JA. \| title = Extra pontine osmotic demyelination syndrome. \| journal = Ann Neurosci \| volume = 22 \| issue = 1 \| pages = 51-3 \| month = Jan \| year = 2015 \| doi = 10.5214/ans.0972.7531.220212 \| PMID = 26124552 }}</ref>

	==General==		==General==

Michael: split out

2017-08-18T14:54:26Z

split out

New page

'''Osmotic demyelination syndrome''', abbreviated '''ODS''', is a demyelination associated with osmotic imbalances.

It classically affect the [[pons]] and was previously known as '''central pontine myelinolysis'''.<ref name=pmid24745890>{{Cite journal | last1 = Alleman | first1 = AM. | title = Osmotic demyelination syndrome: central pontine myelinolysis and extrapontine myelinolysis. | journal = Semin Ultrasound CT MR | volume = 35 | issue = 2 | pages = 153-9 | month = Apr | year = 2014 | doi = 10.1053/j.sult.2013.09.009 | PMID = 24745890 }}</ref>

==General==
*Classically in the pons, ergo "pontine" is in the name.
*Classically midline, ergo "central" is in the name.
**May occur elsewhere -- known as ''extrapontine myelinolysis''.

Etiology:
*Rapid correction of hyponatremia.<ref name=pmid22080394>{{Cite journal | last1 = Chang | first1 = Y. | last2 = An | first2 = DH. | last3 = Xing | first3 = Y. | last4 = Qi | first4 = X. | title = Central pontine and extrapontine myelinolysis associated with acute hepatic dysfunction. | journal = Neurol Sci | volume = | issue = | pages = | month = Nov | year = 2011 | doi = 10.1007/s10072-011-0838-3 | PMID = 22080394 }}</ref>
*Tacrolimus post-liver transplant.<ref name=pmid21959523>{{Cite journal | last1 = Fukazawa | first1 = K. | last2 = Nishida | first2 = S. | last3 = Aguina | first3 = L. | last4 = Pretto | first4 = E. | title = Central pontine myelinolysis (CPM) associated with tacrolimus (FK506) after liver transplantation. | journal = Ann Transplant | volume = 16 | issue = 3 | pages = 139-42 | month = Sep | year = 2011 | doi = | PMID = 21959523 }}</ref>
*Associated with [[alcoholism]] and malnourishment.

Clinical:<ref>{{Cite journal | last1 = Lai | first1 = CC. | last2 = Tan | first2 = CK. | last3 = Lin | first3 = SH. | last4 = Chen | first4 = HW. | title = Central pontine myelinolysis. | journal = CMAJ | volume = 183 | issue = 9 | pages = E605 | month = Jun | year = 2011 | doi = 10.1503/cmaj.090186 | PMID = 21543311 | PMC = 3114939 | URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114939/?tool=pubmed }}</ref>
*Decreased level of consciousness - most common.
*Quadriplegia.
*Poor prognosis.

==Microscopic==
Features:<ref name=npw_ch6>URL: [http://neuropathology-web.org/chapter6/chapter6dCPM.html http://neuropathology-web.org/chapter6/chapter6dCPM.html]. Accessed on: 20 December 2011.</ref>
*Myelin loss.
*No inflammation.
*Relative preservation of neurons.

===Images===
<gallery>
File:Pontine myelinolysis.jpg | Luxol fast blue (LFB stain) in a case of central pontine myelinolysis (WC/jensflorian)
File:Pontine myelinolysis myelinophages.jpg | Myelinophages in CPM showing intracellular myelin fragments (WC/jensflorian)
</gallery>

====www====
*[http://neuropathology-web.org/chapter6/images6/6-9l.jpg CPM (neuropathology-web.org)].<ref name=npw_ch6>URL: [http://neuropathology-web.org/chapter6/chapter6dCPM.html http://neuropathology-web.org/chapter6/chapter6dCPM.html]. Accessed on: 20 December 2011.</ref>
*[http://dartmed.dartmouth.edu/spring09/html/virtual_microscopy_we/ CPM (dartmouth.edu)].

==See also==
*[[Neuropathology]].

==References==
{{Reflist|1}}

[[Category:Neuropathology]]
[[Category:Diagnosis]]

← Older revision		Revision as of 10:13, 22 June 2018
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	*[http://neuropathology-web.org/chapter6/images6/6-9l.jpg CPM (neuropathology-web.org)].<ref name=npw_ch6>URL: [http://neuropathology-web.org/chapter6/chapter6dCPM.html http://neuropathology-web.org/chapter6/chapter6dCPM.html]. Accessed on: 20 December 2011.</ref>		*[http://neuropathology-web.org/chapter6/images6/6-9l.jpg CPM (neuropathology-web.org)].<ref name=npw_ch6>URL: [http://neuropathology-web.org/chapter6/chapter6dCPM.html http://neuropathology-web.org/chapter6/chapter6dCPM.html]. Accessed on: 20 December 2011.</ref>
	*[http://dartmed.dartmouth.edu/spring09/html/virtual_microscopy_we/ CPM (dartmouth.edu)].		*[http://dartmed.dartmouth.edu/spring09/html/virtual_microscopy_we/ CPM (dartmouth.edu)].

			DDx:
			*MS /ADEM.
			*PACNS - Primary angiitis of the central nervous system.
			*CLIPPERS - Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids.


	==See also==		==See also==