Central pontine myelinolysis is a disease of the brain. It is a neurological disorder. It involves damage to nerve fibers.
What is central pontine myelinolysis?
Central pontine myelinolysis is a rare disease of the nerve fibers in the brain. The sheathing of the nerves becomes damaged, leading to symptoms. The word “pontine” is derived from the “pons.” These are located in the brain and are part of the brain stem there. The pons are located between the medulla oblongata, also known as the medulla oblongata, and the midbrain. If you look at the side of the head, they are located approximately behind the ears. In the pons, information from the internal auditory canal as well as the facial area is received and transmitted to the cerebellum. The cerebellum. The transport of sensory information is carried out by the nerve fibers in this region. Nerves can be sheathed. This is called myelination. Myelination causes the electrical signals to stay within the nerve fiber and travel faster to their destination. Without the sheathing, there would be a migration of the signals into the area surrounding the nerve pathway. This leads to a reduction of the signal. Central pontine myelinolysis causes the protection of the sheath to be reduced or even completely lost due to damage.
Causes
Causes of central pontine myelinolysis include any disease or disorder associated with a change in the concentration of sodium in the organism. In most cases, this is what is known as hyponatremia. This is an electrolyte disorder that causes a sodium deficiency. If this state of sodium deficiency persists for a longer period of time, central pontine myelinolysis occurs via the hyponatremia. The causes of hyponatremia vary. They range from eating disorders to hormonal imbalances to alcoholism or side effects of medications. In addition, the condition can occur with faulty infusion therapy. Eating disorders such as anorexia often result in a low-salt diet. At the same time, sufferers consume high amounts of fluids, which in turn result in sodium excretion. Malnutrition and anorexia are characterized by a long course of the disease, so there may be a deficiency of sodium in the blood. The same applies to alcoholism. During the course of the disease, malnutrition also occurs. This results in the sufferer not consuming important amounts of minerals.
Symptoms, complaints and signs
Central pontine myelinolysis causes damage to the nerves in the area of the pons. As a result, their functional activity is impaired. Signals are transmitted at a slower rate or do not reach the organ that can identify and process them. The damage to the nerve fibers leads to discomfort as well as pain in the head area at the level of the ear. There may be disturbances or loss of consciousness. In patients of central pontine myelinolysis, disorientation as well as confusion are perceived. In severe cases, patients experience a comatose state. Brainstem functions are impaired in central pontine myelinolysis. This results in circulatory disturbances and concomitant dysfunction of the brainstem. There are disturbances in eye movements and swallowing. In some cases, there are problems with speech formation. Articulation changes and voice formation causes difficulties for the patient. In addition, patients show unsteadiness of gait. Some patients experience paralysis or partial paralysis of the face. In addition, paralysis of breathing may occur. This is a life-threatening situation.
Diagnosis and course of the disease
In the course of the disease, there is a possibility of a life-threatening condition. If the disease is treated properly, a full recovery can occur. However, complete recovery of all symptoms experienced is not always a given. Diagnosis is made after other conditions have been surveyed, as well as by imaging techniques such as magnetic resonance therapy. If the body is supplied with sufficient sodium, improvement occurs. The period of recovery is considered to be between two weeks to one year.
Complications
If central pontine myelinolysis is properly diagnosed and treated in a timely manner, there are generally no serious complications to worry about.However, since this disease is very rare, it is often not recognized or only recognized very late. The disease can then take a severe course in which the typical symptoms, in particular pain in the area of the ear as well as disorientation and confusion, occur more frequently. The function of the brain stem can be impaired due to circulatory disorders. This can affect the speech center and
speech formation. The patient then often has difficulty forming certain sounds, and often the voice pattern also changes. Problems with swallowing and a resulting impairment in food intake are also conceivable. Other possible complications include balance disorders leading to an unsteady gait and paralysis in the facial region. If respiratory paralysis also occurs, the patient’s life is in acute danger. In very severe cases, patients may also fall into a coma. A rare but repeatedly documented complication is the so-called locked-in syndrome. In this case, all limbs and the speech apparatus are completely paralyzed. The affected person can usually only communicate with his environment by blinking, although he is mentally fully conscious.
When should you see a doctor?
Disorders of eating behavior or excessive consumption of alcohol should generally lead the affected person to seek medical help. In particular, an increase in destructive behavior threatens health problems that should be counteracted in time. In case of disorientation, cognitive disorders as well as irregularities in blood circulation, a visit to the doctor is necessary. Problems with speech, gait insecurities, reductions in performance or states of confusion must be medically examined and treated. Changes in personality, abnormalities in behavior and irregularities in memory are warning signs that must be followed up as soon as possible. In acute cases, the affected person requires intensive medical care. Therefore, a doctor should be consulted at an early stage in the event of disorders of consciousness. If a loss of consciousness occurs, an ambulance service should be alerted. Irregularities in eye movements and abnormalities in swallowing should also be investigated. The affected person needs help as soon as possible, as soon as paralysis or other failures of muscle activity occur. If left untreated or in an advanced stage of the disease, a life-threatening situation may develop. Therefore, it is advisable to seek the cooperation of a physician already at the first deterioration of the general health condition. Changes in lifestyle are necessary so that complications or severe disease progression can be averted at the earliest possible stage. In addition, irreparable damage to the organism may occur at an advanced stage of the disease.
Treatment and therapy
There is no known spontaneous cure for central pontine myelinolysis. Even if the sodium level in the blood has a recommended value, the damage to the sheathing of the nerves is still present. Nevertheless, with proper treatment, complete recovery can occur. The process of regeneration takes several months, and in chronic hyponatremia it is not expected that the damage will disappear. For this reason, treatment of central pontine myelinolysis focuses on the symptoms that occur. In addition, blood sodium levels are measured at short intervals and sodium intake is closely monitored. If patients experience paralysis of a single area of the face, this is treated with targeted physiotherapy and appropriate exercises. If the paralysis symptoms occur in the respiratory area, the patient is artificially ventilated. In case of swallowing difficulties, a tracheotomy is performed. This is a tracheotomy that is used to gain access to the windpipe.
Prevention
As a preventive measure, sodium levels are measured and monitored via regular blood checks. The level of sodium in the blood should not be less than 126 mmol/l. In addition, the intake of food can be used to check that the body is supplied with salt-containing minerals regularly and in sufficient quantities. This can be done through food as well as fluids.
Aftercare
People who suffer or have suffered from the disease should make significant lifestyle changes. Since the disease is based on disturbed eating behavior, affected individuals should constantly monitor and adjust their diet. However, if malnutrition is still present, the organism of affected persons must be supplied with sufficient vitamins and nutrients. In order to achieve lasting relief from the symptoms, a balanced and above all healthy diet is very important for those affected. Since the disease is often a great burden, it is advisable to undergo permanent psychological counseling. Many sufferers are often emotionally unstable and do not manage to cope with the disease on their own and thus achieve an improvement. For this reason, it could also be helpful for those affected to join a self-help group. There, new methods can be learned that will make it easier to deal with the disease. Affected persons can also exchange information about the disease with other sufferers and thus do not feel left alone. Contact with family and relatives is also important. This support makes it easier for those affected to cope with the disease and find a way out. The regular doctor’s visits are mandatory for those affected. The consumption of alcohol or nicotine should be refrained from affected persons.
This is what you can do yourself
People suffering from central pontine myelinolysis need to review their lifestyle and show a willingness to make changes. The causes of the condition can often be based on eating disorders or addictive behavior. Therefore, the diet must be monitored and should be optimized if possible. If malnutrition is present, sufficient nutrients and vitamins must be supplied to the organism. A balanced and healthy diet is particularly important for patients to achieve relief from their symptoms. In many cases, parallel psychological care is helpful. Patients suffering from this disease are often unable to bring about a lasting and stable improvement in their life situation by their own efforts. Therefore, the use of adequate help is advisable. Patients should show the will to change and work cooperatively with medical professionals or specialists. Honesty and the creation of a basis of trust between patient and doctor are of a special importance. Consumption of alcohol or non-prescribed medications should be refrained from. Sufficient fluids should be consumed, and periods of rest and recuperation should be taken regularly. It can also be helpful if the opportunities offered for regular health checks are accepted. In this way, changes in health can be analyzed quickly and measures for improvement can be initiated immediately.