{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T05:30:18Z","timestamp":1772515818429,"version":"3.50.1"},"reference-count":15,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>Central pontine myelinolysis is a demyelinating disorder that arises due to osmolar disturbances in the cerebral microenvironment characterised by loss of the myelin sheath of neurons. The diffusion-weighting imaging sequence of MRI is the most sensitive diagnostic imaging modality for myelinolysis. The rapid correction of hyponatraemia by &gt;20\u201325\u2005mmol\/L\/48\u2005h has been known for a long time as a prime cause of osmotic demyelination. Various other comorbidities in hyponatraemic patients are well known that can lead to osmotic demyelination such as alcoholism, hypoxaemia, severe liver disease, malignancy, burns, liver transplantation and malnutrition. Chronic alcohol abusers with additional liver disease and malnutrition have altered osmotic equilibrium at baseline that predisposes them to osmotic demyelination. We suggest a more cautious and meticulous approach should be followed in these patients to avoid the dreaded complication.<\/jats:p>","DOI":"10.1136\/bcr-2013-009970","type":"journal-article","created":{"date-parts":[[2013,6,28]],"date-time":"2013-06-28T11:42:19Z","timestamp":1372419739000},"page":"bcr2013009970","source":"Crossref","is-referenced-by-count":13,"title":["Central pontine myelinolysis with meticulous correction of hyponatraemia in chronic alcoholics"],"prefix":"10.1136","volume":"2013","author":[{"given":"Konark","family":"Malhotra","sequence":"first","affiliation":[{"name":"Department of Neurology, Drexel University College of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Ortega","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Temple School of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,6,21]]},"reference":[{"key":"2025082722124029000_2013.jun21_1.bcr2013009970.1","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1001\/archneurpsyc.1959.02340140020004","article-title":"Central pontine myelonolysis: a hitherto undescribed disease occurring in alcoholic and malnourished patients","volume":"2013","author":"Adams","year":"1959","journal-title":"Arch Neurol Psychiatry"},{"key":"2025082722124029000_2013.jun21_1.bcr2013009970.2","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1111\/j.1365-2044.2007.05341.x","article-title":"Osmotic demyelination syndrome following rapid correction of hyponatremia","volume":"2013","author":"Snell","year":"2008","journal-title":"Anaesthesia"},{"key":"2025082722124029000_2013.jun21_1.bcr2013009970.3","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/0006-8993(93)91564-9","article-title":"Rapid correction of hyponatremia produces differential effects on brain osmolyte and electrolyte reaccumulation in rats","volume":"2013","author":"Verbalis","year":"1993","journal-title":"Brain Res"},{"issue":"Suppl1","key":"2025082722124029000_2013.jun21_1.bcr2013009970.4","doi-asserted-by":"crossref","first-page":"S12","DOI":"10.1016\/j.amjmed.2006.05.003","article-title":"Brain volume regulation in response to hypo-osmolality and its correction","volume":"2013","author":"Sterns","year":"2006","journal-title":"Am J Med"},{"key":"2025082722124029000_2013.jun21_1.bcr2013009970.5","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s00234-012-1083-z","article-title":"Value of diffusion-weighted imaging in central pontine and extrapontine myelinolysis","volume":"2013","author":"F\u00f6rster","year":"2013","journal-title":"Neuroradiology"},{"key":"2025082722124029000_2013.jun21_1.bcr2013009970.6","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/00000441-200307000-00004","article-title":"Treatment of symptomatic hyponatremia","volume":"2013","author":"Decaux","year":"2003","journal-title":"Am J Med Sci"},{"key":"2025082722124029000_2013.jun21_1.bcr2013009970.7","first-page":"F18","article-title":"Symptomatic hyponatremia in rats: effect of treatment on mortality and brain lesions","volume":"2013","author":"Ayus","year":"1989","journal-title":"Am J Physiol"},{"key":"2025082722124029000_2013.jun21_1.bcr2013009970.8","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1001\/archneur.1983.04050020028004","article-title":"A hypothesis of osmotic endothelial injury. 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