Osmotic demyelination syndrome: Difference between revisions
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'''Osmotic demyelination syndrome''', abbreviated '''ODS''', is a demyelination associated with osmotic imbalances. | '''Osmotic demyelination syndrome''', abbreviated '''ODS''', is a demyelination associated with osmotic imbalances. | ||
It classically affect the | It classically affect the pons and was previously known as '''central pontine myelinolysis'''.<ref name=pmid24745890>{{Cite journal | last1 = Alleman | first1 = AM. | title = Osmotic demyelination syndrome: central pontine myelinolysis and extrapontine myelinolysis. | journal = Semin Ultrasound CT MR | volume = 35 | issue = 2 | pages = 153-9 | month = Apr | year = 2014 | doi = 10.1053/j.sult.2013.09.009 | PMID = 24745890 }}</ref> The name was changed as it is now recognized that it can occur extrapontine.<ref name=pmid26124552>{{Cite journal | last1 = Zunga | first1 = PM. | last2 = Farooq | first2 = O. | last3 = Dar | first3 = MI. | last4 = Dar | first4 = IH. | last5 = Rashid | first5 = S. | last6 = Rather | first6 = AQ. | last7 = Basu | first7 = JA. | last8 = Ashraf | first8 = M. | last9 = Bhat | first9 = JA. | title = Extra pontine osmotic demyelination syndrome. | journal = Ann Neurosci | volume = 22 | issue = 1 | pages = 51-3 | month = Jan | year = 2015 | doi = 10.5214/ans.0972.7531.220212 | PMID = 26124552 }}</ref> | ||
==General== | ==General== | ||
*Classically in the pons | *Classically in the pons. | ||
*Classically midline, ergo "central" | *Classically midline, ergo "central" was previously in the name. | ||
**May occur elsewhere - | **May occur elsewhere - previously referred to as ''extrapontine myelinolysis''. | ||
Etiology: | Etiology: | ||
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*Quadriplegia. | *Quadriplegia. | ||
*Poor prognosis. | *Poor prognosis. | ||
*May cause ''locked-in syndrome'' - inability to produce voluntary responses with preservation of intellectual capacity.<ref name=pmid25379502>{{Cite journal | last1 = Sohn | first1 = MK. | last2 = Nam | first2 = JH. | title = Locked-in Syndrome due to Central Pontine Myelinolysis: Case Report. | journal = Ann Rehabil Med | volume = 38 | issue = 5 | pages = 702-6 | month = Oct | year = 2014 | doi = 10.5535/arm.2014.38.5.702 | PMID = 25379502 }}</ref> | |||
==Microscopic== | ==Microscopic== | ||
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*[http://neuropathology-web.org/chapter6/images6/6-9l.jpg CPM (neuropathology-web.org)].<ref name=npw_ch6>URL: [http://neuropathology-web.org/chapter6/chapter6dCPM.html http://neuropathology-web.org/chapter6/chapter6dCPM.html]. Accessed on: 20 December 2011.</ref> | *[http://neuropathology-web.org/chapter6/images6/6-9l.jpg CPM (neuropathology-web.org)].<ref name=npw_ch6>URL: [http://neuropathology-web.org/chapter6/chapter6dCPM.html http://neuropathology-web.org/chapter6/chapter6dCPM.html]. Accessed on: 20 December 2011.</ref> | ||
*[http://dartmed.dartmouth.edu/spring09/html/virtual_microscopy_we/ CPM (dartmouth.edu)]. | *[http://dartmed.dartmouth.edu/spring09/html/virtual_microscopy_we/ CPM (dartmouth.edu)]. | ||
DDx: | |||
*[[Multiple sclerosis|MS]] /[[Acute disseminated encephalomyelitis|ADEM]]. | |||
*PACNS - Primary angiitis of the central nervous system. | |||
*CLIPPERS - Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids. | |||
==See also== | ==See also== | ||