Skip Navigation

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (88)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by ILLOWSKY, B. P.
Right arrow Articles by LAURENO, R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by ILLOWSKY, B. P.
Right arrow Articles by LAURENO, R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Brain, Vol. 110, No. 4, 855-867, 1987
© 1987 Guarantors of Brain

research-article

ENCEPHALOPATHY AND MYELINOLYSIS AFTER RAPID CORRECTION OF HYPONATRAEMIA

BARBARA P. ILLOWSKY2 and ROBERT LAURENO

(From the Department of Neurology, Washington Hospital Center, and the Department of Neurology, George Washington University School of Medicine Washington, DC, USA)

Correspondence to: 1Presented in part at the American Society of Nephrology, Washington, DC, in 1984, and in part at the Endocrine Society, Baltimore, MD, in 1985.

Considerable controversy has followed the recent publication of studies indicating that central pontine myelinolysis is caused by rapid correction of hyponatraemia. Alternative suggestions have been that myelinolysis is due to uncorrected hyponatraemia, that it occurs only with over-correction of hyponatraemia or that it is due to coincidental hypoxia. The following experiments were undertaken to clarify the relationship between myelinolysis and derangements of serum sodium and their treatment. Severe hyponatraemia ([Na+] <= 122mmol/l) was produced in three groups of rabbits by injection of vasopressin and 5% dextrose in water. Rabbits with severe uncorrected hyponatraemia sustained for seven days or more did not show myelinolysis at autopsy. Myelinolytic lesions did develop in 3 of 7 rabbits in a second group in which corrective infusion of hypertonic saline was administered after only three days of severe hyponatraemia. Neurological deterioration also occurred in rabbits in the third group which received hypertonic saline within 24 h of developing severe hyponatraemia. In this group no lesions were apparent at autopsy. No animal became hypernatraemic with correction. These results indicate that even prolonged severe hyponatraemia does not lead to myelinolysis if it remains uncorrected, but that rapid correction of hyponatraemia, without over-correction, can cause neurological disease. Accordingly, a rapid rise in serum sodium should be avoided.

Received August 29, 1986. Accepted October 16, 1986.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 J Child NeurolHome page
W. D. Brown and J. M. Caruso
Extrapontine Myelinolysis With Involvement of the Hippocampus in Three Children With Severe Hypernatremia
J Child Neurol, July 1, 1999; 14(7): 428 - 433.
[Abstract] [PDF]

Home page
 Arch NeurolHome page
J. D. Weissman and B. M. Weissman
Pontine Myelinolysis and Delayed Encephalopathy Following the Rapid Correction of Acute Hyponatremia
Arch Neurol, August 1, 1989; 46(8): 926 - 927.
[Abstract] [PDF]

Home page
 Arch NeurolHome page
D. B. Clifford, M. H. Gado, and B. K. Levy
Osmotic Demyelination Syndrome: Lack of Pathologic and Radiologic Imaging Correlation
Arch Neurol, March 1, 1989; 46(3): 343 - 347.
[Abstract] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.