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Osmotic demyelination syndrome

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https://www.readbyqxmd.com/read/29557753/hyperglycemic-hyperosmolar-state-a-pragmatic-approach-to-properly-manage-sodium-derangements
#1
Marco Baldrighi, Pier Paolo Sainaghi, Mattia Bellan, Ettore Bartoli, Luigi Mario Castello
INTRODUCTION: Although hypovolemia remains the most relevant problem during acute decompensated diabetes in its clinical manifestations (diabetic ketoacidosis, DKA, and hyperglycemic hyperosmolar state, HHS), the electrolyte derangements caused by the global hydroelectrolytic imbalance usually complicate the clinical picture at presentation and may be worsened by treatment itself. AIM: This review article is focused on the management of dysnatremias during hyperglycemic hyperosmolar state with the aim of providing clinicians a useful tool to early indentify the sodium derangement in order to address properly its treatment...
March 19, 2018: Current Diabetes Reviews
https://www.readbyqxmd.com/read/29547197/osmotic-demyelination-syndrome-in-the-setting-of-hypernatremia
#2
Neeraj Jain, Rajendra V Phadke, Gaurav Chauhan, S P Ambesh
No abstract text is available yet for this article.
March 2018: Neurology India
https://www.readbyqxmd.com/read/29540223/tongue-fasciculations-with-denervation-pattern-in-osmotic-demyelination-syndrome-a-case-report-of-diagnostic-dilemma
#3
H M M T B Herath, S P Pahalagamage, Sunethra Senanayake
BACKGROUND: The pathogenesis of osmotic demyelination syndrome is not completely understood and usually occurs with severe and prolonged hyponatremia, particularly with rapid correction. It can occur even in normonatremic patients, especially who have risk factors like alcoholism, malnutrition and liver disease. Bilateral tongue fasciculations with denervation pattern in electromyogram is a manifestation of damage to the hypoglossal nucleus or hypoglossal nerves. Tongue fasciculations were reported rarely in some cases of osmotic demyelination syndrome, but the exact mechanism is not explained...
March 14, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29340311/hyponatremia-and-the-brain
#4
REVIEW
Fabrice Gankam Kengne, Guy Decaux
Hyponatremia is defined by low serum sodium concentration and is the most common electrolyte disorder encountered in clinical practice. Serum sodium is the main determinant of plasma osmolality, which, in turn, affects cell volume. In the presence of low extracellular osmolality, cells will swell if the adaptation mechanisms involved in the cell volume maintenance are inadequate. The most dramatic effects of hyponatremia on the brain are seen when serum sodium concentration decreases in a short period, allowing little or no adaptation...
January 2018: KI Reports
https://www.readbyqxmd.com/read/29250757/acute-onset-of-parkinsonism-an-end-stage-renal-disease-patient
#5
Chun-Hao Lai, Yu-Wei Hsu, Jiunn-Tay Lee, Yaw-Don Hsu, Chun-An Cheng, Chia-Kuang Tsai
PURPOSE: The osmotic demyelination syndrome (ODS) has been identified as a neurological complication of the rapid correction of hyponatremia. In recent years, however, various medical conditions have been associated with the development of ODS, irrelevant to changes in serum sodium. We present a rare case of a eunatremic patient who developed ODS with manifestation of parkinsonism. CASE: A 55 years old woman who has hypertension, type 2 diabetes nephropathy in end-stage renal disease under maintenance hemodialysis came to us with complaint about newly developed resting tremor of bilateral upper limbs, slowness of movements and small shuffling steps...
June 15, 2017: Acta Neurologica Taiwanica
https://www.readbyqxmd.com/read/29180859/hyponatremia-in-the-elderly-challenges-and-solutions
#6
REVIEW
Theodosios D Filippatos, Andromachi Makri, Moses S Elisaf, George Liamis
Decreased serum sodium concentration is a rather frequent electrolyte disorder in the elderly population because of the presence of factors contributing to increased antidiuretic hormone, the frequent prescription of drugs associated with hyponatremia and also because of other mechanisms such as the "tea and toast" syndrome. The aim of this review is to present certain challenges in the evaluation and treatment of hyponatremia in the elderly population and provide practical solutions. Hyponatremia in elderly subjects is mainly caused by drugs (more frequently thiazides and antidepressants), the syndrome of inappropriate antidiuretic hormone secretion (SIAD) or endocrinopathies; however, hyponatremia is multifactorial in a significant proportion of patients...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29168586/regional-oligodendrocytopathy-and-astrocytopathy-precede-myelin-loss-and-blood-brain-barrier-disruption-in-a-murine-model-of-osmotic-demyelination-syndrome
#7
Joanna Bouchat, Bruno Couturier, Catherine Marneffe, Fabrice Gankam-Kengne, Benoît Balau, Kathleen De Swert, Jean-Pierre Brion, Luc Poncelet, Jacques Gilloteaux, Charles Nicaise
The osmotic demyelination syndrome (ODS) is a non-primary inflammatory disorder of the central nervous system myelin that is often associated with a precipitous rise of serum sodium concentration. To investigate the physiopathology of ODS in vivo, we generated a novel murine model based on the abrupt correction of chronic hyponatremia. Accordingly, ODS mice developed impairments in brainstem auditory evoked potentials and in grip strength. At 24 hr post-correction, oligodendrocyte markers (APC and Cx47) were downregulated, prior to any detectable demyelination...
March 2018: Glia
https://www.readbyqxmd.com/read/29143062/-intracranial-cystic-lesions
#8
REVIEW
F Ahlhelm, K Shariat, S Götschi, S Ulmer
CLINICAL PROBLEM: Intracerebral cysts are common findings in imaging of the neurocranium and are not always clinically significant. The pathological spectrum of intracerebral cysts is, however, very broad and in addition to incidental findings includes developmental disorders, malformation tumors, primary and secondary neoplasms and infectious etiologies, such as cerebral abscess formation, cysticercosis or residuals after congenital cytomegalovirus infections. Intracerebral cystic defects may be caused by inflammatory central nervous system (CNS) diseases, such as multiple sclerosis as well as by mitochondriopathies, leukodystrophy, electrolyte disturbances or osmotic demyelination syndrome or brain infarctions, e...
February 2018: Der Radiologe
https://www.readbyqxmd.com/read/29061503/outcomes-in-severe-hyponatremia-treated-with-and-without-desmopressin
#9
Thomas E MacMillan, Rodrigo B Cavalcanti
BACKGROUND: Overcorrection of plasma sodium in severe hyponatremia is associated with osmotic demyelination syndrome. Desmopressin (DDAVP) can prevent overcorrection of plasma sodium in hyponatremia. The objective of this study was to compare outcomes in hyponatremia according to DDAVP usage. METHODS: This was a retrospective observational study including all admissions to internal medicine with hyponatremia (plasma sodium concentration <123 mEq/L) from 2004 to 2014 at 2 academic hospitals in Toronto, Canada...
March 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/28892600/the-suspect-siadh
#10
Kristen Tee, Jerry Dang
BACKGROUND: Hyponatraemia is one of the most commonly encountered electrolyte abnormalities in general practice. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is an important but under-recognised cause. OBJECTIVE: This article explores the presentation, investigation, diagnosis and management of SIADH. DISCUSSION: SIADH can occur secondary to medications, malignancy, pulmonary disease, or any disorder involving the central nervous system...
September 2017: Australian Family Physician
https://www.readbyqxmd.com/read/28810281/-hyponatremia-differential-diagnosis-and-treatment
#11
REVIEW
Heiner Mönig, Alexander Arlt
Hyponatremia is the most common electrolyte abnormality seen in hospitalized patients, with up to 30 % having a plasma sodium concentration below 135 mmol/l. It is now clear that the clinical problem extends beyond the neurological symptoms, which can be explained by intracerebral osmotic fluid shifts and brain edema. Instead, chronic hyponatremia is associated with impaired gait stability and an increased risk of bone fragility fractures. Moreover, hyponatremia has been demonstrated to be an indicator of poor prognosis in a variety of conditions...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28598055/the-mexican-hat-sign-in-osmotic-demyelination-syndrome
#12
Lulup Kumar Sahoo, Ashok Kumar Mallick, Kali Prasanna Swain, Geeta Mohanty, Maheswar Samanta, Bijay Kumar Mohanty
No abstract text is available yet for this article.
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28509122/severe-hyponatremia-in-a-patient-with-schizophrenia-associated-with-prolonged-consciousness-disturbance
#13
Kunihiko Yasuda, Takatsugu Iwashita, Yosuke Tayama, Yuko Makino, Ayumu Watanabe, Tatsuro Sano, Taisuke Shimizu, Tomonari Ogawa, Koichi Kanozawa, Hajime Hasegawa
Hyponatremia presents with various central nervous system symptoms during its course and treatment. We treated a patient who presented with a prolonged consciousness disorder and was suspected of having complications of neuroleptic malignant syndrome and osmotic demyelination syndrome (ODS) during the treatment for his hyponatremia, which was caused by syndrome of inappropriate secretion of antidiuretic hormone (SIADH). The patient was a 30-year-old Japanese man who had been under treatment for schizophrenia...
May 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28500261/osmotic-demyelination-syndrome-in-type-1-diabetes-in-the-absence-of-dyselectrolytaemia-an-overlooked-complication
#14
Chandramohan Sharma, Banshi Lal Kumawat, Maulik Panchal, Mohit Shah
Central pontine myelinolysis (CPM) is a demyelinating disorder of central nervous system which involves central portion of the pons and sometimes extrapontine areas also. It is commonly reported in settings of hyponatraemia or its rapid correction, but in the last few years it has also been reported in patients with diabetes in the absence of electrolyte disturbances or correction of serum osmolality. Here we report a case of a 20-year-old female patient, with a known history of type 1 diabetes mellitus, who presented with acute onset spastic quadriparesis with dysarthria and mild ataxia which evolved over 2 weeks...
May 12, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28462557/osmotic-demyelination-syndrome-in-a-eunatremic-patient-with-chronic-kidney-disease
#15
Nikhil Gupta, Mufazzal Ahmad, Jalees Fatima, Ritu Karoli, Ahraz Ahmad
Osmotic demyelination syndrome is classically associated with rapid correction of hyponatremia. However, it can occur in normonatremic patients with other electrolyte abnormalities. One must suspect osmotic demyelination syndrome in susceptible patients with other electrolyte abnormalities like hypokalemia and hypophosphatemia.
March 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28458891/severe-symptomatic-hyponatremia-associated-with-the-use-of-polyethylene-glycol-based-bowel-preparation
#16
Navira Samad, Ian Fraser
SUMMARY: Colonoscopy is a useful tool in modern medicine and is increasingly employed for both diagnostic and treatment reasons. However, its effectiveness is highly reliant on the quality of bowel cleansing. Among different bowel-cleansing agents available, PEG (polyethylene glycol) is considered to be the safest cleansing agent, especially in relation to fluid and electrolyte problems. We present here a case of severe symptomatic hyponatremia that developed after the use of PEG for an elective colonoscopy...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28437822/osmotic-demyelination-syndrome-due-to-severe-hyponatremia-mimicking-hypoxic-encephalopathy
#17
Felix Wicke, Sasha Moreitz, Stefan Weidauer
Hyponatremia and its rapid correction is a well-known cause of osmotic demyelination most commonly affecting the pons. We report on a case of severe hyponatremia likely due to psychogenic polydipsia resulting in hypotonic hyperhydration with resulting cortical laminar necrosis on initial imaging, mimicking hypoxic brain damage. Pontine myelinolysis became apparent on follow-up imaging, illustrating the diagnostic challenges of extrapontine manifestations of severe hyponatremia.
April 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28422408/prevention-of-the-osmotic-demyelination-syndrome-after-liver-transplantation-a-multidisciplinary-perspective
#18
REVIEW
J F Crismale, K A Meliambro, S DeMaria, D B Bronster, S Florman, T D Schiano
The osmotic demyelination syndrome (ODS) is a serious neurologic condition that occurs in the setting of rapid correction of hyponatremia. It presents with protean manifestations, from encephalopathy to the "locked-in" syndrome. ODS can complicate liver transplantation (LT), and its incidence may increase with the inclusion of serum sodium as a factor in the Mayo End-Stage Liver Disease score. A comprehensive understanding of risk factors for the development of ODS in the setting of LT, along with recommendations to mitigate the risk of ODS, are necessary...
October 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28321080/the-improvement-of-the-outcome-of-osmotic-demyelination-syndrome-by-plasma-exchange
#19
Saeko Kumon, Ryosuke Usui, Shinzo Kuzuhara, Kosaku Nitta, Minako Koike
A 71-year-old Japanese woman presented with progressive fatigue, lethargy, dysarthria and a gait disorder. Her laboratory data revealed hyponatremia (Na 101 mEq/L), and we started correcting her serum sodium level. Within a few days, she became comatose, bedridden, and was intubated. We diagnosed osmotic demyelination syndrome (ODS) and started performing plasma exchange (PE) on the 39th day of hospitalization. She fully recovered after starting PE, and was discharged on foot unassisted. PE can be a beneficial treatment in patients with chronic ODS...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28315624/extrapontine-myelinolysis-manifested-selectively-by-acute-severe-parkinsonian-syndrome-case-report
#20
IIvana Stetkarova, Zuzana Svobodova, Jozef Soltez, Jinda Svatova
OBJECTIVES: Osmotic demyelination syndrome (ODMS) is a rare and serious neurologic disorder with acute myelin disintegration, usually in the pontine area (central pontine myelinolysis) and to a lesser extent, even in other areas of the central nervous system (extrapontine myelinolysis). The main underlying mechanism is the change of serum osmolality with quick correction of low mineral levels, mainly hyponatraemia. Clinical manifestation is various and depends on the localization. DESIGN: We describe an acute isolated extrapontine myelinolysis causing acute onset of parkinsonism in a 61-year-old man who developed quickly progressing parkinsonian syndrome after the rapid correction of hyponatraemia...
November 2016: Neuro Endocrinology Letters
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