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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
- Osmotic demyelination syndrome (ODS)
Synonyms
- Formerly called central pontine myelinolysis (CPM) &/or extrapontine myelinolysis (EPM)
Definitions
- Acute demyelination caused by rapid shifts in serum osmolality
- Classic setting: Rapid correction of hyponatremia
- ODS may occur in normonatremic patients
IMAGING
General Features
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Cheo SW et al: Trident sign in osmotic demyelination syndrome. QJM. 113(2):131-2, 2020
- Danyalian A et al: Central pontine myelinolysis, 2020
- Bansal LR et al: Osmotic demyelination syndrome in children. Pediatr Neurol. 97:12-7, 2019
- Garg P et al: Osmotic demyelination syndrome - evolution of extrapontine before pontine myelinolysis on magnetic resonance Imaging. J Neurosci Rural Pract. 10(1):126-35, 2019
- Lambeck J et al: Central pontine myelinosis and osmotic demyelination syndrome. Dtsch Arztebl Int. 116(35-36):600-6, 2019
- Shah P et al: More haste, less speed: hyponatraemia and osmotic demyelination. Lancet. 392(10160):2213, 2018
- Buffington MA et al: Hyponatremia: a review. J Intensive Care Med. 31(4):223-3, 2015
- Alleman AM: Osmotic demyelination syndrome: central pontine myelinolysis and extrapontine myelinolysis. Semin Ultrasound CT MR. 35(2):153-9, 2014
- Harring TR et al: Disorders of sodium and water balance. Emerg Med Clin North Am. 32(2):379-401, 2014
- Landais A: Central pontine myelinolysis without electrolyte disorder, alcoholism or denutrition. J Neurol Sci. 343(1-2):235-6, 2014
- Singh TD et al: Central pontine and extrapontine myelinolysis: a systematic review. Eur J Neurol. 21(12):1443-50, 2014
- de Souza A: Movement disorders and the osmotic demyelination syndrome. Parkinsonism Relat Disord. 19(8):709-16, 2013
- Popescu BF et al: Evidence of aquaporin involvement in human central pontine myelinolysis. Acta Neuropathol Commun. 1(1):40, 2013
- Verbalis JG et al: Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med. 126(10 Suppl 1):S1-42, 2013
- Vaidya C et al: Management of hyponatremia: providing treatment and avoiding harm. Cleve Clin J Med. 77(10):715-26, 2010
- Zeidel ML: Hyponatremia: mechanisms and newer treatments. Endocr Pract. 16(5):882-7, 2010
- de Morais BS et al: Central pontine myelinolysis after liver transplantation: is sodium the only villain? Case report. Rev Bras Anestesiol. 59(3):344-9, 2009
- Howard SA et al: Best cases from the AFIP: osmotic demyelination syndrome. Radiographics. 29(3):933-8, 2009
- Mount DB: The brain in hyponatremia: both culprit and victim. Semin Nephrol. 29(3):196-215, 2009
- Roh JH et al: Cortical laminar necrosis caused by rapidly corrected hyponatremia. J Neuroimaging. 19(2):185-7, 2009
- Ruiz S et al: [Severe hyponatraemia and central pontine myelinolysis: be careful with other factors!.] Ann Fr Anesth Reanim. 28(1):96-9, 2009
- Fong CS: [Neurological complications in uremia.] Acta Neurol Taiwan. 17(2):117-26, 2008
- Hoshino Y et al: [Pontine hemorrhage in a patient with type 1 renal tubular acidosis associated with osmotic demyelination syndrome.] Brain Nerve. 60(9):1061-5, 2008
- Laczi F: [Etiology, diagnostics and therapy of hyponatremias.] Orv Hetil. 149(29):1347-54, 2008
- Zamboli P et al: [Hyponatremia secondary to inappropriate antidiuretic hormone secretion.] G Ital Nefrol. 25(5):554-61, 2008
- Guo Y et al: Central pontine myelinolysis after liver transplantation: MR diffusion, spectroscopy and perfusion findings. Magn Reson Imaging. 24(10):1395-8, 2006
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
- Osmotic demyelination syndrome (ODS)
Synonyms
- Formerly called central pontine myelinolysis (CPM) &/or extrapontine myelinolysis (EPM)
Definitions
- Acute demyelination caused by rapid shifts in serum osmolality
- Classic setting: Rapid correction of hyponatremia
- ODS may occur in normonatremic patients
IMAGING
General Features
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Cheo SW et al: Trident sign in osmotic demyelination syndrome. QJM. 113(2):131-2, 2020
- Danyalian A et al: Central pontine myelinolysis, 2020
- Bansal LR et al: Osmotic demyelination syndrome in children. Pediatr Neurol. 97:12-7, 2019
- Garg P et al: Osmotic demyelination syndrome - evolution of extrapontine before pontine myelinolysis on magnetic resonance Imaging. J Neurosci Rural Pract. 10(1):126-35, 2019
- Lambeck J et al: Central pontine myelinosis and osmotic demyelination syndrome. Dtsch Arztebl Int. 116(35-36):600-6, 2019
- Shah P et al: More haste, less speed: hyponatraemia and osmotic demyelination. Lancet. 392(10160):2213, 2018
- Buffington MA et al: Hyponatremia: a review. J Intensive Care Med. 31(4):223-3, 2015
- Alleman AM: Osmotic demyelination syndrome: central pontine myelinolysis and extrapontine myelinolysis. Semin Ultrasound CT MR. 35(2):153-9, 2014
- Harring TR et al: Disorders of sodium and water balance. Emerg Med Clin North Am. 32(2):379-401, 2014
- Landais A: Central pontine myelinolysis without electrolyte disorder, alcoholism or denutrition. J Neurol Sci. 343(1-2):235-6, 2014
- Singh TD et al: Central pontine and extrapontine myelinolysis: a systematic review. Eur J Neurol. 21(12):1443-50, 2014
- de Souza A: Movement disorders and the osmotic demyelination syndrome. Parkinsonism Relat Disord. 19(8):709-16, 2013
- Popescu BF et al: Evidence of aquaporin involvement in human central pontine myelinolysis. Acta Neuropathol Commun. 1(1):40, 2013
- Verbalis JG et al: Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. Am J Med. 126(10 Suppl 1):S1-42, 2013
- Vaidya C et al: Management of hyponatremia: providing treatment and avoiding harm. Cleve Clin J Med. 77(10):715-26, 2010
- Zeidel ML: Hyponatremia: mechanisms and newer treatments. Endocr Pract. 16(5):882-7, 2010
- de Morais BS et al: Central pontine myelinolysis after liver transplantation: is sodium the only villain? Case report. Rev Bras Anestesiol. 59(3):344-9, 2009
- Howard SA et al: Best cases from the AFIP: osmotic demyelination syndrome. Radiographics. 29(3):933-8, 2009
- Mount DB: The brain in hyponatremia: both culprit and victim. Semin Nephrol. 29(3):196-215, 2009
- Roh JH et al: Cortical laminar necrosis caused by rapidly corrected hyponatremia. J Neuroimaging. 19(2):185-7, 2009
- Ruiz S et al: [Severe hyponatraemia and central pontine myelinolysis: be careful with other factors!.] Ann Fr Anesth Reanim. 28(1):96-9, 2009
- Fong CS: [Neurological complications in uremia.] Acta Neurol Taiwan. 17(2):117-26, 2008
- Hoshino Y et al: [Pontine hemorrhage in a patient with type 1 renal tubular acidosis associated with osmotic demyelination syndrome.] Brain Nerve. 60(9):1061-5, 2008
- Laczi F: [Etiology, diagnostics and therapy of hyponatremias.] Orv Hetil. 149(29):1347-54, 2008
- Zamboli P et al: [Hyponatremia secondary to inappropriate antidiuretic hormone secretion.] G Ital Nefrol. 25(5):554-61, 2008
- Guo Y et al: Central pontine myelinolysis after liver transplantation: MR diffusion, spectroscopy and perfusion findings. Magn Reson Imaging. 24(10):1395-8, 2006
