Central Pontine Nyelinolysis

[Dryghten]

My mother has menetiers disease and in January underwent another operation which was successful, however she developed a staff infection and came out of two comas. We have been told now she has Central Pontine Nyelinolysis(?) which we suspect was from an aggressive treatment to sodium levels. She's been released from the major hospital as they don't believe there is anything more they can do for her there and is currently in the local hospital of her home town which has limited facilities. When relocated she was completely unable to move or speak and had just began to breath on her own. She still has a feeding tube but since her relocation she has spoken though the words are often difficult to understand and her vocabulary is limited. She also has movement in her right arm which is becoming more controlled. My question is if there is any treatment we could consider to help her recovery and whether or not a full recovery is likely? We are kind of 'flying blind' as the local doctor and nurses have not had any experience with this condition. Besides the menetriers disease she was in good health prior to the operation, still working with no other medical or physical limitations.

[Dr Rajgopal]

Hi,
You are right in assuming that Central pontine myelinolysis is due to rapid correction of low blood sodium levels. Coma and other symptoms are due to the same. Treatment of the condition is symptomatic and supportive.
Supportive care requires judicious treatment of electrolyte disturbances to reduce the incidence of osmotic myelinolysis. Hyponatremia should be corrected at a rate of 10 µmol/L/24 h. Maximum vitamin supplementation should be given to help in relieving the symptoms soon. Nutritional status must be evaluated. Physiotherapy and psychotherapy must be arranged for to facilitate a speedy recovery. Please consult a neurologist for evaluation and treatment. Hope this helps you. Take care and regards!

[Dryghten]

Thankyou for the information and quick response, it is a great help to us. I am wondering if you would be able to explain to me what osmotic myelinolysis is and perhaps symptoms that may present so that we know what to look for. Thankyou again, Regards Dryghten.