| 
                            
                                
                                Published in IJCP
                                November 2018
                            
                                     
                            
                                INTERNAL MEDICINE
                                
 
                                Is It Structural or Metabolic? A Diagnostic Dilemma
                             
                                November 04, 2018 | E Sumanraj, N Vijayakumar, A Nanjilkumaran, R Umarani
                             
                                
                             
                                
                                
                             
                                Osmotic demyelination syndrome (ODS), a disease affecting chronic alcoholic and malnourished patients was described by
Adams and colleagues in 1959. It is also known as pontine myelinolysis. Pontine myelinolysis can be subdivided into central
pontine myelinolysis (CPM) and extrapontine myelinolysis (EPM) depending upon the level of demyelination, within the
pons or outside the pons, respectively. Rapid correction of hyponatremia contributes to the pathogenesis of ODS. Whenever
a chronic alcoholic and/or malnourished develops confusion, quadriplegia, pseudobulbar palsy and pseudocoma (Lockedin-
syndrome) over a period of several days, a high index of suspicion for ODS must be held.
                             |