Epidemiology
Etiology
Pathophysiology
Clinical features
Diagnostics
Treatment
Complications
Osmotic demyelination syndrome (ODS)
- Definition: damage to the myelin sheath of the white matter in the CNS caused by a sudden rise in serum osmolality
- Central pontine myelinolysis
- Most common type
- Affects the central region of the pons
- Causes
- Iatrogenic: rapid correction of chronic hyponatremia
- Rapid changes in other osmotically active solutes (e.g., glucose)
- Clinical features
- Symptoms first develop several days after the correction of hyponatremia.
- There can be a wide range of symptoms, depending on the degree and location of demyelination.
- Central pontine myelinolysis
- Altered level of consciousness, including coma
- Locked-in syndrome
- Impaired cranial nerve function: dysarthria, dysphagia, and diplopia
- Worsening quadriparesis (initially flaccid, later spastic)
- As a result of corticospinal fiber (UMN) involvement in the basilar pons