Central pontine myelinolysis is brain cell dysfunction caused by the destruction of the layer (
Osmotic demyelination syndrome
Causes, incidence, and risk factors
The destruction of the myelin sheath that covers nerve cells prevents signals from being properly transmitted from one nerve to another.
The most common cause of central pontine myelinolysis is a quick rise in the body’s sodium levels. This most often occurs when someone is being treated for low blood levels of sodium (
This condition does not occur on its own. It is a complication of treatment for other conditions or from the other conditions themselves.
Malnutritionfrom serious illnesses
- Balance problems
- Difficulty swallowing
Reduced alertness, drowsiness or sleepiness, lethargy, poor responses
- Speech changes, poor enunciation
- Weakness in the face, arms, or legs, usually affecting both sides of the body
Signs and tests
An examination may show:
Involvement of all four arms and legs (spastic quadriplegia)
Weakness of the face, arms, and legs (upper motor neuron syndromes)
Other tests may include:
- Blood sodium levels and other blood tests
Brainstem auditory evoked response(BAER)
This is an emergency disorder. You will need to go to a hospital for diagnosis and treatment. However, most people with this condition are already in the hospital for another condition.
There is no known cure for central pontine myelinolysis. Treatment is focused on relieving symptoms.
Physical therapy may help maintain muscle strength, mobility, and function in weakened arms and legs.
The nerve damage caused by central pontine myelinolysis is usually long-lasting. The disorder can cause serious long-term (chronic) disability.
- Decreased ability to interact with others
- Decreased ability to work or care for self
- Inability to move, other than to blink eyes (“locked in” syndrome)
- Permanent nervous system damage
Calling your health care provider
There is no real guideline on when to seek medical attention, because this condition is rare in the general community.
Gradual, controlled treatment of low sodium levels may reduce the risk of nerve damage in the pons. Being aware of how some medications can change sodium levels can prevent these levels from changing too quickly.