Central pontine myelinolysis (CPM):
Neurodegenerative disorder characterised by noninflammatory myelin destruction in the pons (basis pontis); mostly in adults, but has been reported in children as young as 3; associated with rapid correction of hyponatraemia and alcoholism; pathogenesis likely to be an osmotic injury to cells from rapid rise in serum sodium release of myelinotoxic factors; develop spastic bulbar paralysis, quadriplegia, dysarthria, dysphasia, corticospinal reflex changes, tremor, incontinence; prevention – slow correction of hyponatraemia; usually fatal, but survival is characterised by neurological dysfunction.
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