How do you test for osmotic demyelination?

A head MRI scan may reveal a problem in the brainstem (pons) or other parts of the brain. This is the main diagnostic test. Other tests may include: Blood sodium level and other blood tests.

Can you recover from osmotic demyelination?

The symptoms are often irreversible or only partially reversible, and they include dysarthria, dysphagia, tetraparesis, behavioral disturbances, lethargy, confusion, disorientation, and coma (2). When CPM develops after the rapid correction of hyponatremia, plasma exchange (PE) may be a beneficial therapy.

What are symptoms of osmotic demyelination syndrome?

Symptoms of osmotic demyelination (eg, dysarthria, dysphagia, seizures, altered mental status, quadriparesis, hypotension) typically begin 1-5 days after correction of serum sodium level. The condition is typically irreversible and often devastating.

What is osmotic demyelination syndrome?

Central Pontine Myelinolysis (Osmotic Demyelination Syndrome) Central pontine myelinolysis (CPM) is a neurological condition that happens in the pons area of your brain. In CPM, a rapid increase of sodium to correct low sodium levels (hyponatremia) damages nerve cells.

How rare is osmotic demyelination?

[9] Though, the exact incidence of ODS is not known, an autopsy based study documented a prevalence rate of 0.25–0.5% in the general population[7] and 10% in patients undergoing liver transplantation.

Who is at risk for osmotic demyelination?

Among the risk factors for ODS, an SNa ≤105 mEq/L was reported in seven patients, hypokalemia in five, malnutrition in 11, alcohol use disorder in 11, and liver disease in six (Figure 2).

Is osmotic demyelination syndrome progressive?

Osmotic demyelination syndromes are often progressive disorders, with clinical features ranging from a mild tremor or dysarthria to a progressive quadraparesis.

How common is osmotic demyelination syndrome?

How is osmotic demyelination treated?

Plasmapheresis can be considered as an effective treatment modality in chronic osmotic demyelination syndrome.

Can you recover from ODS?

Although ODS may cause permanent disability or death, many patients can have a full or satisfactory spontaneous functional recovery [19,28]. However, recovery with the help of supportive care is unpredictable i.e. unrelated to the severity of the initial presentation [7,28].

Is osmotic demyelination syndrome fatal?

The disorder can resolve completely or result in permanent disability or death. This typical clinical course has been called the osmotic demyelination syndrome (ODS).

Should imaging be used to diagnose osmotic demyelination syndrome?

Imaging performed after symptoms have been present for 2 weeks has been advocated to help confirm the diagnosis, although osmotic demyelination syndrome cannot be excluded with imaging alone (, 5,, 9 ).

What is the first phase of osmotic demyelination?

 The first phase is usually attributable not to the demyelination but rather to the inciting electrolyte abnormality, with patients being acutely encephalopathic. Following rapid reversal of this abnormality, the patient transiently improves before progressing onto the classic osmotic demyelination syndrome features 2-3 days later.

Is osmotic demyelination syndrome more common in males or females?

Osmotic demyelination syndrome affects men more often than women, and it is most common in middle-aged patients (, 2 ).

How does osmotic myelinolysis affect oligodendroglial cells?

Although the exact mechanism is still uncertain, it is known that oligodendroglial cells are most susceptible to osmotic stresses, leading to their demise. It is not surprising that the distribution of osmotic myelinolysis, therefore, parallels the distribution of these cells.