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Science 6 March 1981:
Vol. 211. no. 4486, pp. 1068 - 1070
DOI: 10.1126/science.7466381
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Articles

Science, Vol 211, Issue 4486, 1068-1070
Copyright © 1981 by American Association for the Advancement of Science

articles

Rapid correction of hyponatremia causes demyelination: relation to central pontine myelinolysis

BK Kleinschmidt-DeMasters and MD Norenberg

The human demyelinative disorder central pontine myelinolysis may be an iatrogenic disease caused by a rapid rise in serum sodium, usually when hyponatremia is corrected. Rats treated with hypertonic saline after 3 days of vasopressin-induced hyponatremia had demyelinative lesions in the corpus striatum, lateral hemispheric white matter, cerebral cortex, hippocampal fimbria, anterior commissure, thalamus, brainstem tegmentum, and cerebellum. Thus, rapid correction of hyponatremia can lead to demyelinative lesions and may be the cause of central pontine myelinolysis in man.


THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES:
Therapeutic Effects of Tolvaptan, a Potent, Selective Nonpeptide Vasopressin V2 Receptor Antagonist, in Rats with Acute and Chronic Severe Hyponatremia.
T. Miyazaki, Y. Yamamura, T. Onogawa, S. Nakamura, S. Kinoshita, S. Nakayama, H. Fujiki, and T. Mori (2005)
Endocrinology 146, 3037-3043
   Abstract »    Full Text »    PDF »
Ring-Enhancing Lesion in Central Pontine Myelinolysis.
R. Choksi and E. S. Roach (2005)
Arch Neurol 62, 1016-1017
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Early Diagnosis of Central Pontine Myelinolysis with Diffusion-Weighted Imaging.
K. A. Ruzek, N. G. Campeau, and G. M. Miller (2004)
AJNR Am. J. Neuroradiol. 25, 210-213
   Abstract »    Full Text »    PDF »
The pathophysiology and treatment of hyponatraemic encephalopathy: an update.
M. L. Moritz and J. C. Ayus (2003)
Nephrol. Dial. Transplant. 18, 2486-2491
   Full Text »    PDF »
Hyponatremia.
H. J. Adrogue and N. E. Madias (2000)
N. Engl. J. Med. 342, 1581-1589
   Full Text »    PDF »
Positive association between blood brain barrier disruption and osmotically-induced demyelination.
S Adler, J Martinez, D S Williams, and J G Verbalis (2000)
Multiple Sclerosis 6, 24-31
   Abstract »    PDF »
Extrapontine Myelinolysis With Involvement of the Hippocampus in Three Children With Severe Hypernatremia.
W. D. Brown and J. M. Caruso (1999)
J Child Neurol 14, 428-433
   Abstract »    PDF »
Hyponatremia in Hospitalized Children.
A. Wattad, M. L. Chiang, and L. L. Hill (1992)
Clinical Pediatrics 31, 153-157
   Abstract »    PDF »
Treating Hyponatremia: What Is All the Controversy About?.
T. Berl (1990)
Ann Intern Med 113, 417-419
   Abstract »    PDF »
Osmotic Demyelination Syndrome: Lack of Pathologic and Radiologic Imaging Correlation.
D. B. Clifford, M. H. Gado, and B. K. Levy (1989)
Arch Neurol 46, 343-347
   Abstract »    PDF »
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 (1988)
Arch Neurol 45, 112-114
   Abstract »    PDF »
Severe Symptomatic Hyponatremia: Treatment and Outcome: A Study of 64 Cases.
R. H. STERNS (1987)
Ann Intern Med 107, 656-664
   Abstract »    PDF »
A Hypothesis of Osmotic Endothelial Injury: A Pathogenetic Mechanism in Central Pontine Myelinolysis.
M. D. Norenberg (1983)
Arch Neurol 40, 66-69
   Abstract »    PDF »
Recovery From Probable Central Pontine Myelinolysis Associated With Addison's Disease.
R. S. Kandt, F. J. Heldrich, and H. W. Moser (1983)
Arch Neurol 40, 118-119
   Abstract »    PDF »


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