8A45.31/G37.2 Central pontine myelinolysis

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Aetiology

Central pontine myelinolysis (CPM) is a neurological disorder caused by rapid correction of osmotic imbalances in the body. It is most commonly seen in patients who are hyponatremic, meaning they have a low level of sodium in their blood. This can be due to a variety of causes, including overuse of diuretics or excessive water consumption.

Diagnosis

CPM can be diagnosed by a combination of clinical and imaging findings. Symptoms of CPM include ataxia, dysarthria, dysphagia, spasticity, and other neurological deficits. Magnetic resonance imaging (MRI) of the brain typically shows symmetrical hyperintensities in the central pons.

Differential diagnosis

The differential diagnosis for CPM includes stroke, multiple sclerosis, and Parkinson’s disease.

Treatment

Treatment for CPM is supportive, and includes physical and occupational therapy to help improve motor and speech deficits. Additionally, medications may be used to reduce spasticity and to help with the management of other symptoms.

Prognosis

The prognosis for CPM varies depending on the severity of the condition. Patients who experience milder forms of CPM can often recover with physical and occupational therapy; however, those with more severe forms may have long-term disabilities.

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