Resumen
La mielinolisis osmótica es una patología metabólica que repercute sobre el sistema nervioso central; se considera que ocurre por la rápida corrección de una hiponatremia, lo que conduce a la desmielinización pontina y extrapontina. En este artículo se comentaran brevemente algunos aspectos de esta interesante patología que muchas veces no es diagnosticada y debe ser conocida por el cuerpo médico que maneja paciente críticos. (MED.UIS. 2010;23(2):120-5).
Palabras clave: Mielinolisis hiperosmolar. Hiponatremia. Coma.
Referencias
1. The Acquired Metabolic Disorders of the Nervous System. En: Ropper AH, Samuels MA. Editores: Adams and Victor’s Principles of Neurology. Novena edición. Boston: McGraw-Hill Companies, Inc: 2009.
2. Laureno R, Karp BI. Myelinolysis after correction of hyponatremia. Ann Intern Med 1997;126:57-62.
3. Adams RD, Victor M, Mancall EL. Central pontine myelinolysis: a hitherto undescribed disease occurring in alcoholic and malnourished patients. Arch Neurol Psychiatry 1959;81:154–72.
4. Wright DG, Laureno R, Victor M. Pontine and extrapontine myelinolysis. Brain 1979;102:361-85.
5. Victor M, Laureno R: Neurologic complications of alcohol abuse: Epidemiologic aspects. En: Schoenberg BS. Editor: Advances in Neurology. New York: Raven Press: 1978.
6. Endo Y, Oda M, Hara M. Central pontine myelinolysis. A study of 37 cases in 1000 consecutive autopsies. Acta Neuropathol (Berl.) 1981;53:145-53.
7. Menger H, Jörg J. Outcome of Central pontine and extrapontine myelinolisis (n-44). J Neurol 1999;246:700-5
8. Thompson AJ, Brown MM, Swash M, Thakkar C, Scholtz C. Autopsy validation of MRI in central pontine myelinolysis. Neuroradiology 1988;30:175-7.
9. Goeht A, Colmant HJ. Central pontine and extrapontine myelinolysis: a report of 58 cases. Clin Neuropathol 1987;6(6):262-70.
10. Sterns RH, Cappuccio JD, Silver SM, Cohen EP. Neurologic sequelae after treatment of severe hyponatremia: a multicenter perspective. J Am Soc Nephrol 1994;4:1522-30.
11. Transport of Substances through the Cell Membrane. En: Guyton AC, Hall JE. Editores: Textbook of medical physiology. Eleventh edition. Philadelphia, Pennsylvania. Elsevier, Inc. 2006.
12. Sterns RH, Baer J, Ebersol S, Thomas D, Lohr JW, Kamm DE. Organic osmolytes in acute hyponatremia. Am J Physiol 1993;264:833-6.
13. Lien YH, Shapiro JI, Chan L. Study of brain electrolytes and organic osmolytes during correction of chronic hyponatremia: implications for the pathogenesis of central pontine myelinolysis. J Clin Invest 1991;88:303-9.
14. Verbalis JG, Gullans SR. Hyponatremia causes large sustained reductions in brain content of multiple organic osmolytes in rats. Brain Res 1991;567:274-82.
15. DeLuca GC, Nagy ZS, Esiri MM, Davey P. Evidence for a role for apoptosis in central pontine myelinolysis. Acta Neuropathol 2002;103:590-8.
16. Norenberg MD, Leslie KO, Robertson AS. Association between rise in serum sodium and central pontine myelinolysis. Ann Neurol. 1982;11:128-35.
17. Tomlinson BE, Pierides AM, Bradley WG. Central pontina myelinolysis. Two cases with associated electrolyte disturbance. Q J Med 1976;45:373-86.
18. López-Sendón Moreno J, Vera Lechuga R, Estévez Santé S, Navacerrada Barrero FJ, Corral Corral I. Mielinolisis central pontina y extrapontina: cuadro clínico, resonancia magnética cerebral y evolución en 13 pacientes. Neurología 2009;24(3):165-9.
19. Orakzai RH, Orakzai SH, Hasley PB. Treating hyponatremia: How slow is safe? Central pontine myelinolysis despite appropriate correction of hyponatremia. Eur J Inter Medicine 2008;19:29-31.
20. Lohr JW. Osmotic demyelination syndrome following correction of hyponatremia: association with hypokalemia. Am J Med 1994;96:408-13.
21. Miller RF, Harrison M, Hall-Craggs MA, Scaravilli F. Central pontine myelinolysis in AIDS. Acta Neuropathol 1998;96:537-40.
22. Yi SH, Li H, Yang Y, et al. Major neurological complications following liver transplantation and their management. Nan Fang Yi Ke Da Xue Xue Bao 2007;27(9):1310-3.
23. Boon AP, Carey M, Adams D, Buckels J, McMaster P. Central pontine myelinolysis in liver transplantation. J Clin Pathol 1991;44;909-14.
24. Morais BS, Carneiro FS, Araújo RM, Oliveira RB, Araújo GF. Central Pontine Myelinolysis after Liver Transplantation: is Sodium the Only Villain Case Report. Rev Bras Anestesiol 2009;59(3):344-9.
25. Martin RJ. Central pontine and extrapontine myelinolysis: the osmotic demyelination syndromes. J Neurol Neurosurg Psychiatry 2004; 75 (Suppl. III): 22-28.
26. Bronster DJ, Emre S, Boccagni P, et al. Central nervous system complications in liver transplant recipients: incidence, timing, and long-term follow-up. Clin Transplant 2000;14:1-7.
27. Sterns RH, Cappuccio JD, Silver SM, Cohen EP. Neurologic sequelae after treatment of severe hyponatremia: a multicenter perspective. J Am Soc Nephrol 1994;4:1522-30.
28. Lien YH. Role of organic osmolytes in myelinolysis. A topographic study in rats after rapid correction of hyponatremia. J Clin Invest 1995;95(4):1579-86.
29. Pirzada NA, Ali II. Central pontine myelinolysis. Mayo Clin Proc 2001;76(5):559-62.
30. Leens C, Mukendi R, Foret F, Hacourt A, Devuyst O, Colin IM. Central and extrapontine myelinolysis in a patient in spite of a careful correction of hyponatremia. Clin Nephrol 2001;56(6):490.
2. Laureno R, Karp BI. Myelinolysis after correction of hyponatremia. Ann Intern Med 1997;126:57-62.
3. Adams RD, Victor M, Mancall EL. Central pontine myelinolysis: a hitherto undescribed disease occurring in alcoholic and malnourished patients. Arch Neurol Psychiatry 1959;81:154–72.
4. Wright DG, Laureno R, Victor M. Pontine and extrapontine myelinolysis. Brain 1979;102:361-85.
5. Victor M, Laureno R: Neurologic complications of alcohol abuse: Epidemiologic aspects. En: Schoenberg BS. Editor: Advances in Neurology. New York: Raven Press: 1978.
6. Endo Y, Oda M, Hara M. Central pontine myelinolysis. A study of 37 cases in 1000 consecutive autopsies. Acta Neuropathol (Berl.) 1981;53:145-53.
7. Menger H, Jörg J. Outcome of Central pontine and extrapontine myelinolisis (n-44). J Neurol 1999;246:700-5
8. Thompson AJ, Brown MM, Swash M, Thakkar C, Scholtz C. Autopsy validation of MRI in central pontine myelinolysis. Neuroradiology 1988;30:175-7.
9. Goeht A, Colmant HJ. Central pontine and extrapontine myelinolysis: a report of 58 cases. Clin Neuropathol 1987;6(6):262-70.
10. Sterns RH, Cappuccio JD, Silver SM, Cohen EP. Neurologic sequelae after treatment of severe hyponatremia: a multicenter perspective. J Am Soc Nephrol 1994;4:1522-30.
11. Transport of Substances through the Cell Membrane. En: Guyton AC, Hall JE. Editores: Textbook of medical physiology. Eleventh edition. Philadelphia, Pennsylvania. Elsevier, Inc. 2006.
12. Sterns RH, Baer J, Ebersol S, Thomas D, Lohr JW, Kamm DE. Organic osmolytes in acute hyponatremia. Am J Physiol 1993;264:833-6.
13. Lien YH, Shapiro JI, Chan L. Study of brain electrolytes and organic osmolytes during correction of chronic hyponatremia: implications for the pathogenesis of central pontine myelinolysis. J Clin Invest 1991;88:303-9.
14. Verbalis JG, Gullans SR. Hyponatremia causes large sustained reductions in brain content of multiple organic osmolytes in rats. Brain Res 1991;567:274-82.
15. DeLuca GC, Nagy ZS, Esiri MM, Davey P. Evidence for a role for apoptosis in central pontine myelinolysis. Acta Neuropathol 2002;103:590-8.
16. Norenberg MD, Leslie KO, Robertson AS. Association between rise in serum sodium and central pontine myelinolysis. Ann Neurol. 1982;11:128-35.
17. Tomlinson BE, Pierides AM, Bradley WG. Central pontina myelinolysis. Two cases with associated electrolyte disturbance. Q J Med 1976;45:373-86.
18. López-Sendón Moreno J, Vera Lechuga R, Estévez Santé S, Navacerrada Barrero FJ, Corral Corral I. Mielinolisis central pontina y extrapontina: cuadro clínico, resonancia magnética cerebral y evolución en 13 pacientes. Neurología 2009;24(3):165-9.
19. Orakzai RH, Orakzai SH, Hasley PB. Treating hyponatremia: How slow is safe? Central pontine myelinolysis despite appropriate correction of hyponatremia. Eur J Inter Medicine 2008;19:29-31.
20. Lohr JW. Osmotic demyelination syndrome following correction of hyponatremia: association with hypokalemia. Am J Med 1994;96:408-13.
21. Miller RF, Harrison M, Hall-Craggs MA, Scaravilli F. Central pontine myelinolysis in AIDS. Acta Neuropathol 1998;96:537-40.
22. Yi SH, Li H, Yang Y, et al. Major neurological complications following liver transplantation and their management. Nan Fang Yi Ke Da Xue Xue Bao 2007;27(9):1310-3.
23. Boon AP, Carey M, Adams D, Buckels J, McMaster P. Central pontine myelinolysis in liver transplantation. J Clin Pathol 1991;44;909-14.
24. Morais BS, Carneiro FS, Araújo RM, Oliveira RB, Araújo GF. Central Pontine Myelinolysis after Liver Transplantation: is Sodium the Only Villain Case Report. Rev Bras Anestesiol 2009;59(3):344-9.
25. Martin RJ. Central pontine and extrapontine myelinolysis: the osmotic demyelination syndromes. J Neurol Neurosurg Psychiatry 2004; 75 (Suppl. III): 22-28.
26. Bronster DJ, Emre S, Boccagni P, et al. Central nervous system complications in liver transplant recipients: incidence, timing, and long-term follow-up. Clin Transplant 2000;14:1-7.
27. Sterns RH, Cappuccio JD, Silver SM, Cohen EP. Neurologic sequelae after treatment of severe hyponatremia: a multicenter perspective. J Am Soc Nephrol 1994;4:1522-30.
28. Lien YH. Role of organic osmolytes in myelinolysis. A topographic study in rats after rapid correction of hyponatremia. J Clin Invest 1995;95(4):1579-86.
29. Pirzada NA, Ali II. Central pontine myelinolysis. Mayo Clin Proc 2001;76(5):559-62.
30. Leens C, Mukendi R, Foret F, Hacourt A, Devuyst O, Colin IM. Central and extrapontine myelinolysis in a patient in spite of a careful correction of hyponatremia. Clin Nephrol 2001;56(6):490.
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