Osmotic Demyelination Syndrome Overview
Learn About Osmotic Demyelination Syndrome
Osmotic demyelination syndrome (ODS) leads to brain cell dysfunction. It is caused by the destruction of the layer (myelin sheath) covering nerve cells in the brain, most often the middle of the brainstem (pons).
ODS; Central pontine demyelination; Central pontine myelinolysis
When the myelin sheath that covers nerve cells is destroyed, signals from one nerve to another aren't properly transmitted. Although the brainstem is mainly affected, other areas of the brain can also be involved.
The most common cause of ODS is a quick change in the body's blood sodium levels. This most often occurs when someone is being treated for low blood sodium (hyponatremia) and the sodium is replaced too fast. Sometimes, it occurs when a high level of sodium in the body (hypernatremia) is corrected too quickly.
ODS does not usually occur on its own. Most often, it's a complication of treatment for other problems, or from the other problems themselves.
Risks include:
- Alcohol use
- Liver disease
- Malnutrition from serious illnesses
- Radiation treatment of the brain
- Severe nausea and vomiting during pregnancy
Symptoms may include any of the following:
- Confusion, delirium, hallucinations
- Balance problems, tremor
- Problem swallowing
- Reduced alertness, drowsiness or sleepiness, lethargy, poor responses
- Slurred speech (dysarthria)
- Weakness in the face, arms, or legs, usually affecting both sides of the body
ODS is an emergency disorder that needs to be treated in the hospital though most people with this condition are already in the hospital for another problem.
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.
Mustafa Rahim is an Internal Medicine provider in Beckley, West Virginia. Dr. Rahim and is rated as an Experienced provider by MediFind in the treatment of Osmotic Demyelination Syndrome. His top areas of expertise are Chronic Obstructive Pulmonary Disease (COPD), Necrosis, Anemia, Gastrostomy, and Colonoscopy. Dr. Rahim is currently accepting new patients.
University Physicians And Surgeons, Inc
Murad Kheetan is a Nephrologist in Huntington, West Virginia. Dr. Kheetan and is rated as an Experienced provider by MediFind in the treatment of Osmotic Demyelination Syndrome. His top areas of expertise are Nephrosclerosis, Renovascular Hypertension, Acute Kidney Failure, and Low Sodium Level. Dr. Kheetan is currently accepting new patients.
The nerve damage caused by central pontine myelinolysis is often long-lasting. The disorder can cause serious long-term (chronic) disability.
Complications may include:
- 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
There is no real guideline on when to seek medical attention, because ODS is rare in the general community.
In the hospital, slow, controlled treatment of a low sodium level may reduce the risk for nerve damage in the pons. Being aware of how some medicines can change sodium levels can prevent the level from changing too quickly.
Summary: Hyponatremia is a frequent cause for presentation to the emergency department (ED). While patients with chronic hyponatremia often exhibit minor symptoms, acute development of hyponatremia can lead to global cerebral edema, transtentorial herniation and death. The time course of hyponatremia development is usually not known to the treating physician at presentation. Hence, type and extent of thera...
Published Date: June 13, 2024
Published By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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Yaqoob MM, McCafferty K. Water balance, fluids and electrolytes. In: Feather A, Randall D, Waterhouse M, eds. Kumar and Clark's Clinical Medicine. 10th ed. Philadelphia, PA: Elsevier; 2021:chap 9.