Osmotic demyelination syndrome
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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.[1]
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.[2]
- Tacrolimus post-liver transplant.[3]
- Associated with alcoholism and malnourishment.
Clinical:[4]
- Decreased level of consciousness - most common.
- Quadriplegia.
- Poor prognosis.
Microscopic
Features:[5]
- Myelin loss.
- No inflammation.
- Relative preservation of neurons.
Images
Luxol fast blue (LFB stain) in a case of central pontine myelinolysis (WC/jensflorian)
Myelinophages in CPM showing intracellular myelin fragments (WC/jensflorian)
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See also
References
- ↑ Alleman, AM. (Apr 2014). "Osmotic demyelination syndrome: central pontine myelinolysis and extrapontine myelinolysis.". Semin Ultrasound CT MR 35 (2): 153-9. doi:10.1053/j.sult.2013.09.009. PMID 24745890.
- ↑ Chang, Y.; An, DH.; Xing, Y.; Qi, X. (Nov 2011). "Central pontine and extrapontine myelinolysis associated with acute hepatic dysfunction.". Neurol Sci. doi:10.1007/s10072-011-0838-3. PMID 22080394.
- ↑ Fukazawa, K.; Nishida, S.; Aguina, L.; Pretto, E. (Sep 2011). "Central pontine myelinolysis (CPM) associated with tacrolimus (FK506) after liver transplantation.". Ann Transplant 16 (3): 139-42. PMID 21959523.
- ↑ Lai, CC.; Tan, CK.; Lin, SH.; Chen, HW. (Jun 2011). "Central pontine myelinolysis.". CMAJ 183 (9): E605. doi:10.1503/cmaj.090186. PMC 3114939. PMID 21543311. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114939/.
- ↑ 5.0 5.1 URL: http://neuropathology-web.org/chapter6/chapter6dCPM.html. Accessed on: 20 December 2011.