Osmotic demyelination syndrome
Alerts and Notices
Synopsis

Symptoms depend on the brain regions that are damaged but may include seizures, quadriparesis, hyperreflexia, pseudobulbar palsy, gaze paralysis, diplopia, dysphagia, dysarthria, tremor, ataxia, and altered mental status. There may be a bimodal presentation with acute symptoms followed by several days of improvement and then subacute deterioration. Prognosis is variable and there is a risk of death or chronic disability.
Codes
ICD10CM:G37.2 – Central pontine myelinolysis
SNOMEDCT:
6807001 – Central pontine myelinolysis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Brainstem infarction
- Acute demyelinating encephalomyelitis
- Multiple sclerosis
- Neuromyelitis optica
- Limbic encephalitis
- Brainstem glioma
- Wernicke encephalopathy
- Seizure / status epilepticus
- Spinal cord trauma
- Metabolic encephalopathy
- Hyperammonemia
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:08/07/2018
Last Updated:10/29/2019
Last Updated:10/29/2019