Causes and Symptoms of Central Pontine Myelinolysis (CPM)
What is central pontine myelinolysis disease?
Central pontine myelinolysis (CPM) is a neurologic disease, which leads to a destruction of the myelin sheath surrounding the nerve cells of the brainstem, more specifically in the pons region.
What are the causes, incidence and risk factors associated with central pontine myelinolysis?
Severe damage to the myelin sheath prohibits the proper conduction of brain signals within the nerve cells. This means that there is a decreased ability for cells to communicate with one another.
The most common cause of CPM is a sudden radical change in sodium levels of the body. In other words, the patient is treated for lower levels of sodium (hyponatremia) and there is a sudden rise in the sodium content level in the body. This rapid correction of low blood sodium levels leads to central pontine myelinolysis in the patient body.
The disease is frequently associated with alcoholism. When alcoholics are treated for low sodium levels, a quick correction of sodium levels can lead to CPM. CPM is also caused by or associated with Wernicke-Korsakoff syndrome, undernourishment, and severe illness.
What are common symptoms associated with central pontine myelinolysis?
The following are common symptoms of CPM disease:
• General weakness in the body
• Muscle contractions of the face, arms, or legs
• Double-vision
• Loss of vision
• Fever
• Change in speech or poor accent
• Difficulty eating
• Lack of alertness
• Drowsiness
• Trembling of the hands
• Hallucinations
• Changes in pupil size
• Loss of control of the eye muscles
• Constipation
What are the symptoms of CPM and how is it diagnosed?
This dysfunction of the brain cells is commonly noted as a weakness of the face, arms, and legs (also known as upper motor neuron syndromes). An eye examination may reveal a loss of eye control muscles or cranial nerve VI paralysis (also called as cranial mononeuropathy VI). The patient generally experiences a syndrome in which the body muscles are paralyzed, except for the blinking of the eyes.
The disease can be diagnosed through the use of a head MRI, which can reveal the destruction of the myelin sheath layer. Other tests used in the detection of CPM are tests of sodium levels or a brainstem evoked response audiometry (BERA).
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