Mielinolisis central pontina tras sindrome neuroleptico. Serial brain imaging is of value because a substantial proportion of patients have normal findings on initial mri. Treatment of central pontine myelinolysis with plasmapheresis and immunoglobulins in liver transplant patient. Central pontine myelinolysis cpm and extrapontine myelinolysis epm are rare neurological disorders characterized by demyelination in andor outside the pons. If you continue browsing the site, you agree to the use of cookies on this website. Since its inception in 2003 which was visionary for its time many thousand posters have been submitted to epos, where they are permanently available completely free of charge.
Pdf mielinolisis pontina central e hiponatremia perioperatoria. Gbc 2 hofmann koeffler table 1 world health organization classi. Mielinolise pontina central e extrapontina em paciente alcoolista sem disturbios hidroeletroliticos. Mielinolisis central pontina cerebro y neurociencia. Mielinolisis central pontina en trasplante hepa tico 47 med intensiva 2004.
Magnetic resonance imaging in central pontine myelinolysis. We describe demographics, clinical presentation, and early magnetic resonance imaging mri findings with special. Central pontine myelinolysis cpm is a neurological condition involving severe damage to the myelin sheath of nerve cells in the pons an area of the brainstem. Enfermedades desmielinizantes graves by federico preve. Download as pptx, pdf, txt or read online from scribd. We present the case of a 2yearold girl with symptoms of rapidly progressing obesity, who a few months later developed hypothalamic dysfunction with severe electrolyte imbalance, behaviour disorder, hypoventilation, and severe autonomic dysregulation, among other symptoms. Value of diffusionweighted imaging in central pontine and. Create marketing content that resonates with prezi video. Mielinolisis central pontina tras sindrome neuroleptico maligno sr. Chronic alcoholism or rapid correction of hyponatremia was present in over 75% of cases. A diagnosis of central pontine myelinolysis cpm was made. Extrapontine myelinolysis epm is one of the complications occurring secondary to rapid correction of hyponatremia, and is, along with central pontine myelinolysis encompassed by the more recent term osmotic demyelination syndrome in the vast majority of cases it is associated with central pontine myelinolysis but it can also rarely occur as an isolated entity.
Critically ill patients frequently develop neurologic symptoms, which frequently become a clinical challenge. A mielinolise pontina central mpc e uma doenca desmielinizante aguda causada por oscilacoes abruptas na osmolalidade serica, resultando em desmielinizacao simetrica da parte central da base da ponte. Antemortem computed tomography ct had been performed in nine, and ante or postmortem magnetic resonance mr imaging in 11. Described approximately 50 years ago, pontine neuronal demyelination is a pathologic change associated with neurologic and psychiatric problems after liver transplantation. Equlibrio acidobasico endocrino quimica free 30day. Extrapontine myelinolysis epm is one of the complications occurring secondary to rapid correction of hyponatremia, and is, along with central pontine myelinolysis encompassed by the more recent term osmotic demyelination syndrome. Ocorre esporadicamente em todas as idades 35, acomete os dois sexos igualmente e sua incidencia exata e desconhecida 4. Rapidonset obesity with hypothalamic dysregulation, hypoventilation, and autonomic dysregulation rohhad syndrome. We analyzed the clinical feature, diagnosis and treatment of 4 cpm cases and then compared them with 26 cpm cases reported between 2000 and 2010. T2 weighted image of hyperintensity in the pons black arrow consistent with cpm day 14. Central pontine myelinolysis cpm is a rare and severe neurologic complication characterized by acute central pontine neuronal demyelination along with severe and occasionally irreversible manifestations 1.
Brain mri of the patient showing a low t1 signal intensity lesion day 14. Pdf central pontine myelinolysis is a demyelinating lesion in the basis pontis which in. To discuss the etiology, diagnosis and treatment of central pontine myelinolysis cpm by analyzing 4 cases of our center and 26 cases reported by others in our country. Category peripheral blood bone marrow ra anemia blasts pdf 193 k ver update in endocrinology evidence published in 2010. Central pontine myelinolysis cpm is now more commonly referred to as osmotic demyelination syndrome, which recognizes that the same phenomenon is also seen in other areas of the brain previously known as extrapontine myelinolysis. Saner fh, koeppen s, meyer m, kohnle m, hergetrosenthal s, sotiropoulos gc, et al. Extrapontine myelinolysis radiology reference article. It is predominately iatrogenic treatmentinduced, and is characterized by acute paralysis, dysphagia difficulty swallowing, dysarthria difficulty speaking, and other neurological symptoms. Mielinolisis pontina central e hiponatremia perioperatoria. Although it is believed that fast correction of the plasma levels of sodium is the main cause 2, this report supports the presence of other factors related to the development. Jul 19, 2019 coma mixedematoso ana maria angel isaza residente emergencias universidad icesi slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Pdf mielinolisis central pontina en trasplante hepatico. Clinical analysis of central pontine myelinolysis after. Epos, the electronic presentation online system, is the european society of radiologys online database for electronic scientific exhibits.
Aporte central pontine myelinolysis is a demyelinating affection of central pons diagnosed on the basis of characteristic mri finding in an appropriate clinical setting. Central pontine myelinolysis cpm is a neurological condition involving severe damage to the. Mielinolisis extrapontina secundaria a hiponatremia por. Clinical analysis of central pontine myelinolysis after liver. Clinical and radiologic correlations of central pontine myelinolysis. As such the condition is described in the osmotic demyelination syndrome article. Citescore values are based on citation counts in a given year e. Central pontine myelinolysis after liver transplantation. Convulsiones, estado mental alterado mielinolisis pontina central 82. Psychogenic polydipsia excessive fluid seeking behaviour pdf. We describe demographics, clinical presentation, and early magnetic resonance imaging mri findings. In cases of bowel perforation, ct is the most sensitive technique for depicting free intraperitoneal air and is valuable for determining the cause of the perforation. Sequential observation of movements disorders and brain images in the case of central pontine myelinolisis and extrapontine myelinolsis.