Central Pontine Myelinolysis

Central pontine myelinolysis is a demyelinating disorder affecting the central pons, typically associated with rapid correction of chronic hyponatremia. Clinical features include acute quadriparesis, pseudobulbar palsy, dysarthria, dysphagia, and in severe cases, locked-in syndrome. Pathophysiology involves osmotic stress leading to oligodendrocyte injury and selective myelin loss, sparing axons. Diagnosis is confirmed by MRI demonstrating symmetric pontine lesions. Management is primarily supportive, focusing on prevention through careful correction of electrolyte disturbances; prognosis is variable, with partial recovery possible but severe cases carrying high morbidity and mortality.