Long-term outcome of patients hospitalized in intensive care units with central or extrapontine myelinolysis*

  title={Long-term outcome of patients hospitalized in intensive care units with central or extrapontine myelinolysis*},
  author={Guillaume Louis and Bruno M{\'e}garbane and Sylvain Lavou{\'e} and Vincent Lassalle and Laurent Argaud and Jean François Poussel and Hugues Georges and Pierre Edouard Bollaert},
  journal={Critical Care Medicine},
Objective:Very few data are available for critically ill patients with central or extrapontine myelinolysis and according to available evidence, the prognosis seems to be poor. We aimed to describe the baseline characteristics, the management, the long-term prognosis, and the prognostic factors in central or extrapontine myelinolysis. Design:Retrospective observational study considering modified Rankin Scale score >3 or death as an unfavorable outcome. Setting:Forty-six French intensive care… Expand
Central pontine and extrapontine myelinolysis: a systematic review
ODS is found to have a good recovery in more than half of cases and its mortality has decreased with each passing decade, and favorable prognosis is possible in patients of ODS, even with severe neurological presentation. Expand
Données actuelles et spécificités en réanimation Central pontine and extrapontine myelinolysis . Recent data and management in the intensive care unit
Although earlier reports on CPM/EPM have shown very poor outcome, recent reports suggest better outcome with improved survival and recovery, however, no study has clearly identified any potential prognostic factors in CPM / EPM. Expand
Acute necrotic pancreatitis: A rare and not always fatal cause of central pontine myelinolysis.
The case of a patient admitted for central myelinolysis in a context of acute pancreatitis without hyponatremia is described, following the CARE guidelines. Expand
Rehabilitation of anterior pituitary dysfunction combined with extrapontine myelinolysis: A case report
Rec rehabilitation in a patient with pituitary dysfunction combined with extramedullary myelinolysis who actively participate in rehabilitation intervention can significantly improve their activities of daily living. Expand
The role of the interdisciplinary team in subacute rehabilitation for central pontine myelinolysis
A 30 year-old female with central pontine myelinolysis presenting with incomplete locked-in syndrome is described and chronicles her rehabilitative journey at a comprehensive post-acute rehabilitation center, illustrating the critical role of a patient-centered and goal-driven interdisciplinary team approach in the rehabilitation of persons with central Pontine Myelinolyssis. Expand
Favorable Outcomes Following the Use of Triple Therapy in a Patient with Osmotic Demyelination Syndrome
A case of ODS treated with plasmapheresis, intravenous immunoglobulins, and intravenous methylprednisolone with significant recovery of neurologic function is presented. Expand
Management of Severe Hyponatremia and SIADH
Based on case reports and animal models, urea is an intriguing therapeutic option for correcting serum sodium with reduced risk of ODS, and for preventing ODS in high-risk patients. Expand
Role of Risk Factors in Developing Osmotic Demyelination Syndrome During Correction of Hyponatremia: A Case Study
This case report describes a 57-year-old man who presented first with lethargy and dysarthria due to hyponatremia resulting from poor intake and diuretics and ultimately turned out to have developed an osmotic demyelination syndrome (ODS). Expand
Effective treatment of osmotic demyelination syndrome with plasmapheresis: a case report and review of the literature
A 43-year-old Sri Lankan man presented with fever, repeated vomiting, unsteady gait, increased tonicity of his right upper limb and paucity of speech for three days and was commenced on plasmapheresis twenty-two days after rapid correction of sodium. Expand
Hyponatremia: A Review.
Immediate treatment with hypertonic saline is needed to reduce the risk of permanent neurologic injury andTherapeutic measures to lower the serum sodium level should be undertaken if the rate increases too rapidly. Expand


Clinical and functional outcome and factors predicting prognosis in osmotic demyelination syndrome (central pontine and/or extrapontine myelinolysis) in 25 patients
Higher GCS scores, better scores in functional scales in hospital, less severe hyponatraemia and absence of superadded hypokalaemia predicted favourable outcome. Expand
Outcome of central pontine and extrapontine myelinolysis (n = 44)
It is concluded that patients with cerebral myelinolysis survive if the nonspecific secondary complications of transient illnesses such as aspiration pneumonia, ascending urinary tract infection with subsequent septicemia, deep venous thrombosis, and pulmonary embolism can be avoided. Expand
Withdrawal of support in intracerebral hemorrhage may lead to self-fulfilling prophecies
The data show that individual patients in traditionally “poor outcome” categories can have a reasonable neurologic outcome when treated aggressively, and the most important prognostic variable in determining outcome after ICH is the level of medical support provided. Expand
Central pontine and extrapontine myelinolysis: the osmotic demyelination syndromes
  • R. Martin
  • Medicine
  • Journal of Neurology, Neurosurgery & Psychiatry
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The clinical, pathological, and aetiological features of the disease, the dilemma facing clinicians treating patients with severe hyponatraemia, and treatment opportunities are discussed. Expand
A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study.
The SAPS II, based on a large international sample of patients, provides an estimate of the risk of death without having to specify a primary diagnosis and is a starting point for future evaluation of the efficiency of intensive care units. Expand
Osmotic demyelination syndrome following correction of hyponatremia: association with hypokalemia.
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  • Medicine
  • The American journal of medicine
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In neurologically stable patients with severe hyponatremia, it may be beneficial to correct hypokalemia prior to correction of the serum sodium, which may further reduce the incidence of ODS. Expand
Central pontine and extrapontine myelinolysis: a report of 58 cases.
Extrapontine lesions seem to be more frequent and widespread than has been hitherto reported in the literature and one case with an extreme extension of the lesions is described in detail. Expand
The UK-TIA aspirin trial: Interim results
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