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Osmotic demyelination syndrome

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https://www.readbyqxmd.com/read/28212925/reversible-opercular-syndrome-secondary-to-osmotic-demyelination
#1
Shuchit Pandey, Vikram V Holla, Imran Rizvi, Rakesh Shukla
Opercular syndrome (OPS) is characterized by weakness of facial, masticatory, pharyngeal, laryngeal, tongue and brachial muscles on voluntary command with preservation of emotional and reflexive movements. We report a case of 45year old female who developed the features of OPS due to lesions of bilateral frontal opercular region induced by osmotic demyelination secondary to hyperosmolar hyperglycaemia. On follow up at 6 months, she had complete recovery.
February 11, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28190443/neurologic-manifestations-of-major-electrolyte-abnormalities
#2
M Diringer
The brain operates in an extraordinarily intricate environment which demands precise regulation of electrolytes. Tight control over their concentrations and gradients across cellular compartments is essential and when these relationships are disturbed neurologic manifestations may develop. Perturbations of sodium are the electrolyte disturbances that most often lead to neurologic manifestations. Alterations in extracellular fluid sodium concentrations produce water shifts that lead to brain swelling or shrinkage...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28131203/temporal-evolution-of-the-trident-and-piglet-signs-of-osmotic-demyelination-syndrome
#3
Shin C Beh
Central pontine myelinolysis (CPM) is a potentially-devastating complication of rapid osmolar shifts, classically attributed to overlyaggressive correction of chronic hyponatremia. Magnetic resonance imaging (MRI) allowed earlier diagnosis of CPM, but most importantly, it has revealed that the odds of good functional recovery are surprisingly high. A trident shaped pontine lesion is a typical finding in CPM (the trident sign). The "piglet sign" is a much less well-known radiologic finding in CPM. Due to the rarity of CPM, very little has been published on the evolution of these MRI findings...
February 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28122966/osmotic-stress-induced-defective-glial-proteostasis-contributes-to-brain-demyelination-after-hyponatremia-treatment
#4
Fabrice Gankam-Kengne, Bruno S Couturier, Alain Soupart, Jean Pierre Brion, Guy Decaux
Adequate protein folding is necessary for normal cell function and a tightly regulated process that requires proper intracellular ionic strength. In many cell types, imbalance between protein synthesis and degradation can induce endoplasmic reticulum (ER) stress, which if sustained, can in turn lead to cell death. In nematodes, osmotic stress induces massive protein aggregation coupled with unfolded protein response and ER stress. In clinical practice, patients sustaining rapid correction of chronic hyponatremia are at risk of osmotic demyelination syndrome...
January 25, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27987266/neuroimaging-of-chronic-alcohol-misuse
#5
REVIEW
Caitriona Logan, Hamed Asadi, Hong Kuan Kok, Seamus T Looby, Paul Brennan, Alan O'Hare, John Thornton
Alcohol is one of the most commonly abused substances worldwide. It results in a wide range of diseases and disorders affecting many organ systems. Alcohol-related nutritional deficiencies and electrolyte disturbance leave chronic abusers at risk of a range of demyelinating conditions to which the radiologist and clinician should always be alert. These include Wernicke's encephalopathy, Korsakoff's syndrome, Marchiafava-Bignami disease and osmotic demyelination. Cerebral volume loss is also a commonly encountered neuroimaging phenomenon in chronic alcohol abusers...
December 16, 2016: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/27882183/psychiatric-symptoms-and-limb-tremors-associated-with-central-pontine-myelinolysis-a-case-of-alcoholism-without-hyponatremia
#6
Xue-Min Feng, Teng Zhao, Chun-Kui Zhou, Jing-Yao Liu
Central pontine myelinolysis (CPM), also known as osmotic demyelination syndrome, is a rare demyelinating disorder characterized by the loss of myelin in the center of the basis pontis. In this case report, an alcoholic patient with CPM and acquired demyelinating lesion of the basis pontis is described. The patient is a 70 year-old woman who presented with intermittent psychiatric symptoms and limb tremors following two months of alcohol abuse. During admission, magnetic resonance imaging (MRI) revealed hyperintensity on T2 weighted images and fluid-attenuated inversion-recovery imaging in the central pons without contrast enhancement...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27856078/not-everything-that-shakes-is-a-seizure%C3%A2-role-of-continuous-eeg-in-the-intensive-care-unit
#7
Thomas Ritzenthaler, Chloé Laurencin, Nathalie André Obadia, Carole Bodonian, Frédéric Dailler
Treatment of status epilepticus often requires highly sedative drugs with risk of side effects. Correct diagnosis is mandatory in order to prevent introduction of usefulness treatments. We report a case of suspected myoclonic status epilepticus. A thalamic lesion secondary to an osmotic demyelination syndrome was found to be the likely etiology of the myoclonus. Electrophysiological data (electroencephalography and electromyography) provided evidence for a subcortical origin of myoclonus and use of continuous EEG allowed monitoring of drug withdrawal...
November 14, 2016: Neurophysiologie Clinique, Clinical Neurophysiology
https://www.readbyqxmd.com/read/27851605/1971-a-case-of-hypokalemic-paralysis-caused-by-rta-type-1-resulting-in-osmotic-demyelination-syndrome
#8
Remi Okwechime, Hung-I Liao, Dora Izaguirre-Anariba, Moyna Kapoor, Jesus Lanza, Parvez Mir
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27851457/1822-on-the-cusp-of-overcorrection-osmotic-demyelination-syndrome-treated-with-plasmapheresis-and-ivig
#9
Kaitlin Hanlon, Ryhm Radjef, Jacqueline Pflaum-Carlson, Lenar Yessayan
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27734653/osmotic-demyelination-syndrome-presenting-with-chorea
#10
T Ravindran, Paneerselvam, Radha, T Allwyn Yabesh
Osmotic demyelination syndrome is an acute shift in serum osmolality causing demyelination, which may be due to rapid correction of hyponatremia, hyperglycaemia, hypokalemia and ketoacidosis. We present a case of 55yr old female and a known diabetic presented with the choreic movements involving left upper and lower limb for 2 days without any weakness.Her blood sugar was 428mg/dl at the time of admission with wide fluctuations.Her CT Brain showed hyperdensity in the right basal ganglia and the MRI brain showed hyperintense lesion in T2 weighted images showing features suggestive of osmotic demyelination...
April 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27618323/white-matter-diseases-with-radiologic-pathologic-correlation
#11
Nicolae Sarbu, Robert Y Shih, Robert V Jones, Iren Horkayne-Szakaly, Laura Oleaga, James G Smirniotopoulos
White matter diseases include a wide spectrum of disorders that have in common impairment of normal myelination, either by secondary destruction of previously myelinated structures (demyelinating processes) or by primary abnormalities of myelin formation (dysmyelinating processes). The pathogenesis of many white matter diseases remains poorly understood. Demyelinating disorders are the object of this review and will be further divided into autoimmune, infectious, vascular, and toxic-metabolic processes. Autoimmune processes include multiple sclerosis and related diseases: tumefactive demyelinating lesions, Balo concentric sclerosis, Marburg and Schilder variants, neuromyelitis optica (Devic disease), acute disseminated encephalomyelitis, and acute hemorrhagic leukoencephalopathy (Hurst disease)...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27598428/challenges-in-the-acute-management-of-profound-hyponatremia-presenting-with-severe-symptoms
#12
Yaasir Mamoojee, Rasha Mukhtar
Currently available guidelines in the acute management of severely symptomatic hypotonic hyponatremia vary in their approach to the use of hypertonic saline. In the acute setting, deciding on when to implement available treatment algorithm using hypertonic saline may be difficult, given that the duration of hyponatremia and potential alternative diagnoses presenting with similar symptoms may be hard to establish promptly. We present the case of a young female with symptomatic profound hyponatremia who subsequently developed osmotic demyelination syndrome due to rapid overcorrection of serum sodium concentration...
October 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27592460/osmotic-demyelination-syndrome-after-slow-sodium-administration-in-a-hyponatremic-patient-with-concurrent-hypokalemia
#13
Yin-Chou Hsu, Yu-Chang Lee, Chih-Wei Hsu
No abstract text is available yet for this article.
August 16, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27478591/the-utility-and-accuracy-of-four-equations-in-predicting-sodium-levels-in-dysnatremic-patients
#14
Ramy Magdy Hanna, Wan-Ting Yang, Eduardo A Lopez, Joseph Nabil Riad, James Wilson
BACKGROUND: Improper correction of hyponatremia can cause severe complications, including osmotic demyelination syndrome (ODS). The Adrogué-Madias equation (AM), the Barsoum-Levine (BL) equation, the Electrolyte Free Water Clearance (EFWC) equation and the Nguyen-Kurtz (NK) equation are four derived equations based on the empirically derived Edelman equation for predicting sodium at a later time (Na2) from a known starting sodium (Na1), fluid/electrolyte composition and input and output volumes...
August 2016: Clinical Kidney Journal
https://www.readbyqxmd.com/read/27463219/extrapontine-myelinolysis-associated-with-severe-hypernatremia-in-infancy
#15
Ryoji Aoki, Tetsuji Morimoto, Yuno Takahashi, Hiroshi Saito, Tatsuo Fuchigami, Shori Takahashi
Extrapontine myelinolysis (EPM) is an uncommon disorder in children, with few pediatric cases reported to date. We report the first case of an infant with EPM without central pontine myelinolysis (CPM) presenting with severe hypernatremia. On admission, the infant had impaired consciousness, mild dehydration, and severe hypernatremia (190 mmol/L). The following day, the patient developed abnormal involuntary movements. Brain magnetic resonance imaging (MRI) confirmed EPM without CPM. He recovered without sequelae, and clinical examinations were within normal limits approximately 6 months after discharge...
September 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27405987/normonatremic-osmotic-demyelination-in-the-setting-of-acquired-immune-deficiency-syndrome-and-malnutrition-case-report-and-literature-review
#16
James E Siegler, Amber R Wang, Joshua D Vanderwerf
In this report, we present the case of a 43-year-old woman with AIDS, disseminated aspergillosis, and malnutrition who developed osmotic demyelination syndrome. AIDS-related osmotic demyelination has only been documented in a handful of cases to date, and it appears independent of the classic mechanism of rapid correction of hyponatremia. In this manuscript, we review the six prior cases of osmotic demyelination in AIDS patients and compare their circumstances to that of our own patient. It appears that complications of malnutrition, possibly related to depletion of organic osmolytes in the central nervous system, may place AIDS patients at greater risk of osmotic demyelination...
December 2016: Journal of Neurovirology
https://www.readbyqxmd.com/read/27212829/central-pontine-myelinolysis-in-a-case-of-alcohol-dependence-syndrome
#17
Kaushik Chatterjee, Austin B Fernandes, Sunil Goyal, Sunitha Shanker
Osmotic Demyelination Syndrome includes Central Pontine Myelinolysis and Extrapontine Myelinolysis. This condition has been described in cases of chronic Alcohol Dependence Syndrome and in rapid correction of hyponatremia. Though we frequently see patients with Alcohol Dependence Syndrome presenting with complicated withdrawal, Central Pontine Myelinolysis remains largely undetected and under-reported in literature. We present here a case of protracted Delirium Tremens where MRI brain revealed Central Pontine Myelinolysis...
July 2015: Industrial Psychiatry Journal
https://www.readbyqxmd.com/read/27156756/diagnosis-and-treatment-of-hyponatraemia
#18
REVIEW
S G Ball, Zohaib Iqbal
Hyponatraemia is the most common electrolyte abnormality encountered by physicians in the hospital setting. It is associated with increased mortality and length of hospital stay. However, the basis of the relationship of hyponatraemia with clinical outcome is not clear. Doubt remains as to whether the relationship is causal. It may reflect the association of two independent variables both of which are linked with disease severity. Serum sodium concentration is regulated through integrated neuro-humeral mechanisms that overlap with those regulating circulating volume...
March 2016: Best Practice & Research. Clinical Endocrinology & Metabolism
https://www.readbyqxmd.com/read/27153450/ten-pitfalls-in-the-proper-management-of-patients-with-hyponatremia
#19
REVIEW
Theodosios D Filippatos, George Liamis, Moses S Elisaf
Hyponatremia (serum sodium <135 mEq/L) is a common electrolyte disorder in community or hospitalized patients. Serum sodium levels should be corrected at a proper rate in patients with hyponatremia, since overcorrection of serum sodium levels is related to devastating neurologic consequences, such as the osmotic demyelination syndrome (ODS). However, a number of pitfalls, which could lead to undercorrection or overcorrection of hyponatremia, are common during the treatment of hyponatremic patients. Hereby, we describe ten common pitfalls that are observed during the correction of serum sodium concentration in hyponatremic patients...
June 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27091143/osmotic-demyelination-syndrome-plasmapheresis-versus-intravenous-immunoglobulin
#20
EDITORIAL
Kunakorn Atchaneeyasakul, Anita Tipirneni, Salomon Gloria, Andrew C Berry, Kush Shah, Dileep R Yavagal
No abstract text is available yet for this article.
February 2017: Internal and Emergency Medicine
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