medigraphic.com
Instituto Nacional de Neurología y Neurocirugía

2015, Number 3

<< Back Next >>

Arch Neurocien 2015; 20 (3)

Central pontine myelinolysis with entapment syndrome associated with hypovitaminosis

Enríquez-Coronel G, Cabrera-Espinosa ES

Language: Spanish
References: 42
Page: 221-226
PDF size: 540.19 Kb.


ABSTRACT

Central pontine myelinolysis (CPM) is a non-inflammatory demyelinating disease characterized by destruction of the myelin sheaths level of the pons. The predisposing factors are chronic alcoholism, malnutrition states and rapid correction of disnatremia. Case report: female 54-year-old man who presented sudden quadriplegia and aphasia, initially managed as stroke. Subsequently she presented vertical nystagmus. MRI showed compatible data with central pontine myelinolysis. Hematic cytometry showed megaloblastic anemia. She received supportive therapy and physical rehabilitation, without clinical improvement. Conclusions: this case relates the CPM with hypovitaminosis, rare association in the development of a CPM. No serum levels of B-complex vitamins was done, that would have allowed us to define a more accurate diagnosis. So far, there is no effective treatment for CMP.


REFERENCES

  1. Adams RD, M Victor, Mancall EL. Central pontine myelinolysis: a hitherto undescribed disease occurring in alcoholic and malnourished patients. Arch Neurol Psychiatry 1959;81(2): 154-72.

  2. Tomlinson BE, Pierides AM, Bradley WG. Central pontine myelinolysis: two cases with associated electrolyte disturbance. Q J Med 1976;45(179):373-86.

  3. Laureno R. Rapid correction of hyponatremia: cause of pontine myelinolysis? Am J Med 1981;71:846-7.

  4. Laureno R, Karp BI. Pontine and extrapontine myelinolysis following rapid correction of hyponatraemia. Lancet 1988:1439-41.

  5. Wright DG, Laureno R, Victor M. Pontine and extrapontine myelinolysis. Brain 1979;102:361-85.

  6. R.J. Martin. Central pontine and extrapontine myelinolysis: the osmotic demyelination syndrome. J Neurol Neurosurg Psychiatry 2004;75(Suppl 3):iii22-8.

  7. Gocht A, Colmant HJ. Central pontine and extrapontine myelinolysis: a repor t of 58 cases. Clin Neuropathol 1987;6:262-70.

  8. Newell KL, Kleinschmidt-DeMasters BK. Central pontine myelinolysis at autopsy; a twelve year retrospective analysis. J Neurol Sci 1996;142:134-9.

  9. Snigh N, Yu VL, Gayowski T. Central nervous system lesions in adult liver transplant recipients: clinical review with implications for management. Medicine 1994;73(2):110-8.

  10. Lampl C, Yazdi K. Central pontine myelinolysis. Eur Neurol 2002; 47:3-10.

  11. Musana AK, Yale H. Central pontine myelinolysis: case series and review. Wisconsin Medical Journal 2005;104(6):56-60.

  12. G. Louis, PE Bollaert. Myélinolyse centro- et extrapontine. Données actuelles et spécificités en réanimation. Réanimation 2012;21(5):563-71.

  13. Laitt RD, Thornton M, Goddard P. Pontine myelinolysis in a normonatraemic alcoholic. Clin Radiol 1993;48(6):432-33.

  14. Mascalchi M, Cincotta M, Piazzini M. Case report: MRI demonstration of pontine and thalamic myelinolysis in a normonatraemic alcoholic. Clin Radiol 1993;47(2):137-8.

  15. Cascales Campos P, Ramirez P, Gonzalez R, Pons J, Miras M, Sanchez Bueno F, et al. Central pontine and extrapontine myelinolysis: a rare and fatal complication after liver transplantation. Transplant Proc 2011;43(6):2237-8.

  16. King JD, Rosner MH. Osmotic demyelination syndrome. Am J Med Sci 2010;339(6):561-7.

  17. Bhuvaneswar CG, Baldessarini RJ, Harsh VL, Alpert JE. Adverse endocrine and metabolic effects of psychotropic drugs: selective clinical review. CNS Drugs 2009; 23(12):1003-21.

  18. Crosland L, Longcroft-Wheaton G, Fraser J, Stone A. Antidepressants, thiazide diuretics and alcoholism: central pontine myelinolysis waiting to happen? Br J Hosp Med 2009; 70(5):296-7.

  19. Hurley RA, Filley CM, Taber KH. Central pontine myelinolysis. J Neuropsychiatry Clin Neurosci 2011;23(4):369-74.

  20. Kleinschmidt-Demasters BK, Rojiani AM, Filley CM. Central and extrapontine myelinolysis: then… and now. J Neuropathol Exp Neurol 2006;65(1):1-11.

  21. Alleman AM. Osmotic demyelination syndrome: central pontine myelinolysis and extrapontine myelinolysis. Semin Ultrasound CT MR 2014;35(2):153-9.

  22. Gankam Kengne F, Nicaise C, Soupar t A, Boom A, Schiettecatte J, Pochet R, et al. Astrocytes are an early target in osmotic demyelination syndrome. J Am Soc Nephrol 2011; 22(10):1834-45.

  23. Papadopoulos MC, Verkman AS. Aquaporin-4 and brain edema. Pediatr Nephrol 2007;22(6):778-84.

  24. Popescu BF, Bunyian RF, Guo Y, Parisi JE, Lennon VA, Lucchinetti CF. Evidence of aquaporin involvement in human central pontine myelinolysis. Act Neuropathol Commun 2013; 25(1):1-40.

  25. Ishibashi T, Dakin KA, Stevens B, Lee PR, Kozlov SV, Stewart CL, et al. Astrocytes promote myelination in response to electrical impulses. Neuron 2006;49(6):823-32.

  26. Norenberg MD. Central pontine myelinolysis: historical and mechanistic considerations. Metab Brain Dis 2010 ;25(1):97- 106.

  27. Murase T, Sugimura Y, Takefuji S, Oiso Y, Murata Y. Mechanisms and therapy of osmotic demyelination. Am J Med 2006; 119(7 Suppl 1):S69-73.

  28. Ashrafian H, Davey P. A review of the causes of central pontine myelinosis: yet another apoptotic illness?. Eur J Neurol 2001;8(2):103-9.

  29. Verbalis JG. Brain volume regulation in response to changes in osmolality. Neuroscience 2010;168(4):862-70.

  30. Sen J, Belli A. S100B in neuropathologic states: The CRP of the brain?. J Neurosci Res 2007;85: 1373-80.

  31. de Boer AG, Breimer DD. Cytokines and blood-brain barrier permeability. In: HS Sharma, J Westman , eds. Progress in Brain Research. Elsevier 1998; 115:425-51.

  32. Sakamoto E, Hagiwara D, Morishita Y, Tsukiyama K, Kondo K, et al. Complete recovery of central pontine myelinolysis by high dose pulse therapy with methylprednisolone. Nihon Naika Gakkai Zasshi 2007;96(10):2291-351.

  33. Escribano-Gascón AB, Casanova-Peño LI, Bartolomé-Puras M, Porta-Etessam J. Efficacy of intravenous immunoglobulins in central pontine myelinolysis. Neurol 2008;23(6):392-4.

  34. Zein EF, Karaa SE, Rollot F, Blanche P, Chemaly R. Treatment of central pontine myelinolysis with thyrotropin-releasing hormone. Press Med 2006;35(4 Pt 1):618-20.

  35. Bibl D, Lampl C, Gabriel C, Jüngling J, Brock H, Köstler G. Treatment of central pontine myelinolysis with therapeutic plasmapheresis. Lancet 1999;353(9159):1155.

  36. Nishino K, Yasuda T, Kowada M. A case report of central pontine myelinolysis with neurological recover y after administration of glucocor ticoid. No To Shinkei 1991;43(5):483-8.

  37. Murthy SB, Izadyar S, Dhamne M, Kass JS, Goldsmith CE. Osmotic demyelination syndrome: variable clinical and radiologic response to intravenous immunoglobulin therapy. Neurol Sci 2013;34(4):581-4.

  38. Chemaly R, Halaby G, Mohasseb G, Medlej R, Tamraz J, el- Koussa S. Extrapontine Myelinolysis: treatment with TRH. Rev Neurol (Paris) 1998;154(2):163-5.

  39. Ludwig KP, Thiesset HF, Gayowski TJ, Schwar tz JJ. Plasmapheresis and intravenous immune globulin improve neurologic outcome of central pontine myelinolysis occurring post orthotopic liver transplant. Ann Pharmacother 2011; 45:e10.

  40. Adrogué HJ, Madias NE. Hyponatremia. N Engl J Med 2000;342(21):1581-9.

  41. Sterns RH, Silver SM. Brain volume regulation in response to hypo-osmolality and its correction. Am J Med 2006;119(7 Suppl 1):S12-6.

  42. Decaux G, Andres C, Gankam Kengne F, Soupart. Treatment of euvolemic hyponatremia in the intensive care unit by urea. Crit Care 2010; 14(5):R184.




2020     |     www.medigraphic.com