Osmotic demyelination syndrome (ODS) is brain cell dysfunction. It is caused by the destruction of the layer (myelin sheath) covering nerve cells in the middle of the brainstem (pons).
ODS; Central pontine demyelination
When the myelin sheath that covers nerve cells is destroyed, signals from one nerve to another aren't properly transmitted. Although the brainstem is mainly affected, other areas of the brain can also be involved.
The most common cause of ODS is a quick change in the body's sodium levels. This most often occurs when someone is being treated for low blood sodium (hyponatremia) and the sodium is replaced too fast. Sometimes, it occurs when a high level of sodium in the body (hypernatremia) is corrected too quickly.
ODS does not usually occur on its own. Most often, it's a complication of treatment for other problems, or from the other problems themselves.
Symptoms may include any of the following:
ODS is an emergency disorder that needs to be treated in the hospital though most people with this condition are already in the hospital for another problem.
There is no known cure for central pontine myelinolysis. Treatment is focused on relieving symptoms.
Physical therapy may help maintain muscle strength, mobility, and function in weakened arms and legs.
Thomas Schiano is a Gastroenterologist in Ridgewood, New Jersey. Dr. Schiano has been practicing medicine for over 35 years and is rated as an Elite doctor by MediFind in the treatment of Osmotic Demyelination Syndrome. He is also highly rated in 41 other conditions, according to our data. His top areas of expertise are Hepatitis, Hepatitis C, Liver Transplant, and Osmotic Demyelination Syndrome. He is board certified in Gastroenterology and Internal Medicine and licensed to treat patients in New York. Dr. Schiano is currently accepting new patients.
Fabrice Kengne-Gankam is in Brussels, Belgium. Kengne-Gankam is rated as an Elite expert by MediFind in the treatment of Osmotic Demyelination Syndrome. He is also highly rated in 4 other conditions, according to our data. His top areas of expertise are Osmotic Demyelination Syndrome, Low Sodium Level, Syndrome of Inappropriate Antidiuretic Hormone Secretion, and Bartter Syndrome.
Helbert Rondon-Berrios is a Nephrologist and a Neurologist in Pittsburgh, Pennsylvania. Dr. Rondon-Berrios has been practicing medicine for over 22 years and is rated as an Elite doctor by MediFind in the treatment of Osmotic Demyelination Syndrome. He is also highly rated in 6 other conditions, according to our data. His top areas of expertise are Osmotic Demyelination Syndrome, Low Sodium Level, Osmotic Diuresis, and Syndrome of Inappropriate Antidiuretic Hormone Secretion. He is board certified in Nephrology, Internal Medicine, and Neurology and licensed to treat patients in Pennsylvania. Dr. Rondon-Berrios is currently accepting new patients.
The nerve damage caused by central pontine myelinolysis is often long-lasting. The disorder can cause serious long-term (chronic) disability.
Complications may include:
There is no real guideline on when to seek medical attention, because ODS is rare in the general community.
In the hospital, slow, controlled treatment of a low sodium level may reduce the risk for nerve damage in the pons. Being aware of how some medicines can change sodium levels can prevent the level from changing too quickly.
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Yaqoob MM, McCafferty K. Water balance, fluids and electrolytes. In: Feather A, Randall D, Waterhouse M, eds. Kumar and Clarke's Clinical Medicine. 10th ed. Philadelphia, PA: Elsevier; 2021:chap 9.