21. Patient 73 Test Answer extrapontine myelinolysis following rapid correction of iatrogenic hyponatremia . finding at autopsies of alcoholics with central pontine myelinolysis. http://www.bcm.edu/neurology/challeng/pat75/answer4a.html

Patient #75 Question 4 Extrapontine myelinolysis following rapid correction of iatrogenic hyponatremia. You answered (A). The correct answer is (C). Department of Neurology, Baylor College of Medicine

22. The Journal Of Trauma: Injury, Infection, And Critical Care - UserLogin Central pontine myelinolysis and/or extrapontine myelinolysis are rare Central pontine and extrapontine myelinolysis used to be diagnosed only by http://www.jtrauma.com/pt/re/jtrauma/fulltext.00005373-199803000-00030.htm

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23. Entrez PubMed A case of central pontine and extrapontine myelinolysis with early hypermetabolismon 18FDGPET scan. Roh JK, Nam H, Lee MC. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9

24. Entrez PubMed We report a patient with central pontine and extrapontine myelinolysis owing todisequilibrium syndrome. The patient had depressed consciousness, agitation, http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1

25. Portal Toolkit Invalid Site URL extrapontine myelinolysis after surgical removal of a pituitary tumour extrapontine myelinolysis is a rare and serious disorder characterized by patches http://ppv.ovid.com/pt/re/obes/fulltext.00000132-199809000-00013.htm

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26. Portal Toolkit Invalid Site URL Central pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) are caused by A case of central pontine and extrapontine myelinolysis with early http://ppv.ovid.com/pt/re/obes/fulltext.00000132-200112000-00010.htm

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27. Radiology, University Of Rochester Medical Center Central pontine and extrapontine myelinolysis. The extrapontine alterationswere termed as extrapontine myelinolysis (EPM). http://www.urmc.rochester.edu/smd/Rad/neurocases/Neurocase100.htm

Radiology Home Department Overview Faculty Residency ... E-mail Images below require Macromedia's Flash Player to view Previous Case View Other Brain Degenerative/Demyelination Cases Next Case Neuroradiology Case of the Week Case 100 Xiang Liu, MD, PhD and PL Westesson, MD, PhD, DDS Clinical Presentation: A 54-year-old man, status-post liver transplant one month ago (end stage liver disease secondary to hepatitis C), presented with left facial droop, slurred speech, and had several falls. He was on Tacrolimus for immunosuppression. Radiological Findings: Axial CT images showed swelling in the central pons with low density, which caused the fourth ventricle compression ( Fig. 1 ). There were also several patchy lesions with low density in the periventricular and frontal subcortical areas ( Fig. 2

28. Arch Neurol -- Abstract: Computerized Tomography In The Diagnosis Of Central And extrapontine myelinolysis was suggested on CT scans in both cases, and confirmedin one. Computerized tomography may prove to be a sensitive and accurate http://archneur.ama-assn.org/cgi/content/abstract/38/4/243

Select Journal or Resource JAMA Archives of Dermatology Facial Plastic Surgery Family Medicine (1992-2000) General Psychiatry Internal Medicine Neurology Ophthalmology Surgery Student JAMA (1998-2004) JAMA CareerNet For The Media Meetings Peer Review Congress Vol. 38 No. 4, April 1981 Featured Link E-mail Alerts ARTICLE Article Options Send to a Friend Readers Reply Submit a reply Similar articles in this journal Literature Track Add to File Drawer Download to Citation Manager PubMed citation Articles in PubMed by Thompson DS Norenberg M Articles that cite this article Contact me when this article is cited Computerized tomography in the diagnosis of central and extrapontine myelinolysis D. S. Thompson, J. T. Hutton, J. C. Stears, J. H. Sung and M. Norenberg In two patients the diagnosis of central pontine myelinolysis (CPM), suspected on clinical grounds, was supported by computerized tomographic (CT) sections made perpendicular to the pons, and confirmed on postmortem examination. Extrapontine myelinolysis was suggested on CT scans in both cases, and confirmed in one. Computerized tomography may prove to be a

29. Arch Neurol -- Abstract: Striatal Syndrome Following Hyponatremia And Its Rapid Striatal syndrome following hyponatremia and its rapid correction. A manifestationof extrapontine myelinolysis confirmed by magnetic resonance imaging http://archneur.ama-assn.org/cgi/content/abstract/45/1/112

Select Journal or Resource JAMA Archives of Dermatology Facial Plastic Surgery Family Medicine (1992-2000) General Psychiatry Internal Medicine Neurology Ophthalmology Surgery Student JAMA (1998-2004) JAMA CareerNet For The Media Meetings Peer Review Congress Vol. 45 No. 1, January 1988 Featured Link E-mail Alerts ARTICLE Article Options Send to a Friend Readers Reply Submit a reply Similar articles in this journal Literature Track Add to File Drawer Download to Citation Manager PubMed citation Articles in PubMed by Dickoff DJ Yahr MD Articles that cite this article Contact me when this article is cited Striatal syndrome following hyponatremia and its rapid correction. A manifestation of extrapontine myelinolysis confirmed by magnetic resonance imaging D. J. Dickoff, M. Raps and M. D. Yahr Department of Neurology, Mount Sinai School of Medicine, City University of New York, New York. Several pathologic reports have indicated the occurrence of extrapontine sites of myelinosis associated with electrolyte disturbance and its rapid correction. Clinical evidence of the presence of such lesions, however

30. Journal Of Neuroimaging -- Sign In Page MR findings of central pontine and extrapontine myelinolysis. Satoh T.Serial MRI of extrapontine myelinolysis of the basal ganglia a case report. http://jon.sagepub.com/cgi/content/refs/15/1/85

JOURNAL HOME HELP CONTACT US SUBSCRIPTIONS ... SEARCH QUICK SEARCH: [advanced] Author: Keyword(s): Year: Vol: Page: This item requires a subscription to Journal of Neuroimaging Online. Bilateral Basal Ganglia and Cerebellar Lesions in an Alcoholic Hyperosmolar Patient Dash et al. J Neuroimaging. This Article Abstract Full Text (PDF) References ... Alert me if a correction is posted Services Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal ... Reprints and Permissions PubMed PubMed Citation Articles by Dash, S. Articles by Pullicino, P. To view this item, select one of the options below: Sign In User Name Sign in without cookies. Can't get past this page? Help with Cookies. Need to Activate? Password Forgot your user name or password? Purchase Short-Term Access Pay per Article - You may access this article (from the computer you are currently using) for 1 day for US$25.00 Pay for Admission - You may access all content in Journal of Neuroimaging Online (from the computer you are currently using) for 24 hours for US$75.00.

31. Penn State Faculty Research Expertise Database (FRED) Central Pontine Myelinolysis, extrapontine myelinolysis Myelinolyses,Extrapontine, Myelinolysis, Extrapontine. Faculty Experts http://fred.hmc.psu.edu/ds/retrieve/fred/meshdescriptor/D017590

32. Journal Of Computer Assisted Tomography - UserLogin Karp BI, Laureno R. Pontine and extrapontine myelinolysis a neurologic disorderfollowing rapid correction of hyponatremia. Medicine 1993;7235973. http://www.jcat.org/pt/re/jcat/fulltext.00004728-199811000-00027.htm

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33. CMJ_netprints Pontine and extrapontine myelinolysis caused by hyponatremia Report of two cases.LUO Benyan?,ZHANG Minming?, RUAN Lingxiang?, http://www.cmj.org/netprints/02/06/020611.htm

34. Singapore Medical Journal The latter condition is termed extrapontine myelinolysis (EPM)(1). In both CPMand EPM, bilateral and symmetrical involvement is usually the rule (Figs 2a http://www.sma.org.sg/smj/4101/articles/4101me1ans.htm

Journals Present Issue Past Issues THESMANEWS Present Issue Past Issues SMJ Editorial Board Letters to the Editor Instructions to Authors S I N G A P O R E M E D I C A L J O U R N A L This site is supported by Health ONE Singapore Med J 2000; Vol 41(1): Clinics in Diagnostic Imaging (45) C Y Chan, H S Lam, J R Jinkins IMAGE INTERPRETATION MR scans showede a 1 cm area of T2 hyperintensity in the central pontine region (Fig 1a) . In a patient with a history of sodium replacement, this finding is in keeping with osmotic myelinolysis (or central pontine myelinolysis). Multiple areas of T2 hyperintensity were seen in the basal ganglia and deep white matter (Fig 1b) , representing part of the same process. DIAGNOSIS Osmotic myelinolysis (central pontine myelinolysis) CLINICAL COURSE The patient did not improve clinically over the following months. She developed spastic tetraparesis, pseudobulbar palsy and horizontal nystagmus. Because of mutism, antidepressants were tried but they were not effective. She remained bed-ridden and ventilator-dependent. During her hospital stay, she developed several episodes of chest and urinary tract infection which were controlled with antibiotics. The patient finally died one year later due to multiple organ failure and sepsis. DISCUSSION Osmotic myelinolysis (OM) is a demyelinating disease that can develop following rapid correction of hyponatremia from any cause. It was originally described in chronic alcoholics. Other reported associations include malnourished status, renal failure, diabetes mellitus, and post-orthotopic liver transplantation

35. REFERENCES Karp BI, Laureno R. Pontine and extrapontine myelinolysis a neurologic disorder A case of central pontine and extrapontine myelinolysis with early http://www.sma.org.sg/smj/4101/references/4101me1ref.htm

REFERENCES Ho VB, Fitz CR, Yoder CC, Geyer CA. Resolving MR features in osmotic myelinolysis (central pontine and extrapontine myelinolysis). AJNR 1993; 14:163-7. Martin PJ, Young CA. Central pontine myelinolysis: clinical and MRI correlates. Postgrad Med J 1995; 71:430-42. Laaureno R, Karp BI. Myelinolysis after correction of hyponatremia. Ann Intern Med 1997; 126:57-62. McGraw P, Edwards-Brown MK. Reversal of MR findings of central pontine myelinolysis. J Comput Assist Tomogr 1998; 22:989-91. Gregorio L, Sutton CL, Lee DA. Central pontine myelinolysis in a previously healthy 4-year-old child with acute rotavirus gastroenteritis. Pediatrics 1997; 99:738-43. Karp BI, Laureno R. Pontine and extrapontine myelinolysis: a neurologic disorder following rapid correction of hyponatremia. Medicine (Baltimore) 1993; 72:359-73. Korogi Y, Takahashi M, Shinzato J, Sakamoto Y, Mitsuzaki K, Hirai T, et al. MR findings in two presumed cases of mild central pontine myelinolysis. AJNR 1993; 14:651-4. Gocht A, Colmant HJ. Central pontine and extrapontine myelinolysis: a report of 58 cases. Clin Neuropathol 1987; 6:262-70.

36. JPMA ::: Central and extrapontine myelinolysis in a patient in spite of a careful correctionof hyponatremia. Clin Nephrol 2001;5524853. http://jpma.org.pk/jpma/6june05/fulltex11.htm

Case Report Extra Pontine Myelinolysis associated with Hypophosphatemia Faisal Qadir, Asim Hasan, Moeen Masood* Departments of Medicine and Neurology, Liaquat National Hospital, Karachi and Regions Hospital, University of Minnesota*, St. Paul, Minneapolis, USA. Introduction Focal symmetric demyelination in the CNS may be precipitated by aggressive correction of a hyper or hypoosmolar state - osmotic myelinolysis.1 Since the first descriptions of central pontine myelinolysis (CPM) were put forth in 1959 in alcoholic patients, it has become evident that myelinolysis is not exclusively restricted to the pons. In many cases myelinolysis may share other brain regions, while in still others the pons may not be affected at all - extra-pontine myelinolysis(EPM).2 Hence, specific anatomical locations are more susceptible to demyelination than others. We have reviewed the published cases of extra pontine myelinolysis and believe this to be the first report of EPM occurring in the setting of severe hypophosphatemia.

37. Central Pontine Myelinolysis In A Previously Healthy 4-Year-Old Child With Acute The diagnosis of CPM with extrapontine myelinolysis was made. Thirteen ofthese cases involved exclusively extrapontine myelinolysis. http://pediatrics.aappublications.org/cgi/content/full/99/5/738

QUICK SEARCH: [advanced] Author: Keyword(s): Year: Vol: Page: This Article Extract Full Text (PDF) P ... Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal ... Cited by other online articles PubMed PubMed Citation Articles by Gregorio, L. Articles by Lee, D. A. Related Collections PEDIATRICS Vol. 99 No. 5 May 1997, pp. 738-742 EXPERIENCE AND REASON: Central Pontine Myelinolysis in a Previously Healthy 4-Year-Old Child With Acute Rotavirus Gastroenteritis INTRODUCTION Top Introduction Case Report Discussion References Acute gastroenteritis is one of the most common childhood illnesses encountered today. Vomiting and diarrhea often cause dehydration. Although the disease is usually self-limiting, patients may require rehydration therapy. Central pontine myelinolysis (CPM) is rare, with fewer than 30 cases reported in children. First described in 1959, it is a demyelinating process that affects the central pons and may involve other white matter areas. CPM presents with an altered

38. Myelinolysis, Central Pontine Central Pontine Myelinolysis; extrapontine myelinolysis; Extrapontine Myelinoclasis;Myelinoclasis, Central Pontine; Pontine Myelinolysis, Central; http://medical.webends.com/kw/Myelinolysis, Central Pontine

Medical.WebEnds.com - Medical Terminology Dictionary A B C D ... Z WWW Medical.WebEnds.com Myelinolysis, Central Pontine Central Pontine Myelinolysis; Extrapontine Myelinolysis; Extrapontine Myelinoclasis; Myelinoclasis, Central Pontine; Pontine Myelinolysis, Central; Central Pontine Myelinoclasis; Extrapontine Myelinoclases; Extrapontine Myelinolyses A demyelinating condition affecting the PONS and characterized clinically by an acute progressive QUADRIPLEGIA DYSARTHRIA ; DYSPHAGIA; and alterations of consciousness . Pathologic features include prominent demyelination in the central PONS with sparing of axons and neurons . This condition is usually associated with systemic disorders such as HYPONATREMIA ; chronic ALCOHOLISM LIVER FAILURE ; severe BURNS ; malignant NEOPLASMS ; hemorrhagic PANCREATITIS; HEMODIALYSIS; and SEPSIS . The rapid medical correction of hyponatremia has been cited as a cause of this condition. (From Adams et al., Principles of Neurology , 6th ed, pp1125-6) Google links Processing time was 0.054455995559692 seconds.

39. UCLA Department Of Medicine - Wfsection-Treatment Of Chronic Hyponatremia Wright DG, Laureno R, Victor M. Pontine and extrapontine myelinolysis. Brain . Central pontine and extrapontine myelinolysis a report of 58 cases. http://www.med.ucla.edu/modules/wfsection/article.php?articleid=182

40. Neurology -- Sign In Page Pontine/extrapontine myelinolysis occurring in the setting of an eating disorder.C. Singer, MD , D. Lorenzo, MD , S. Papapetropoulos, MD, PhD , A. Mesa, http://www.neurology.org/cgi/content/full/64/12/2156

HOME HELP FEEDBACK SUBSCRIPTIONS ... SEARCH QUICK SEARCH: [advanced] Author: Keyword(s): Year: Vol: Page: This item requires a subscription to Neurology Online. Full Text Pontine/extrapontine myelinolysis occurring in the setting of an eating disorder Singer et al. Neurology. This Article Full Text (PDF) Correspondence: Submit a response ... Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal ... Download to citation manager PubMed PubMed Citation Articles by Singer, C. Articles by Bowen, B. Related Collections MRI All Medical/Systemic disease Gastrointestinal Nutritional To view this item, select one of the options below: Sign In User Name Sign in without cookies. Can't get past this page? Help with Cookies. Need to Activate? Password Forgot your user name or password? Purchase Short-Term Access Pay per Article - You may access this article (from the computer you are currently using) for 1 day for US$20.00

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