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Central pontine myelinolysis

  • Alternative Names

    Osmotic demyelination syndrome

    • Confusion, delirium
    • Balance problems
    • Difficulty swallowing
    • Hallucinations
    • Reduced alertness, drowsiness or sleepiness, lethargy, poor responses
    • Speech changes, poor enunciation
    • Tremor
    • Weakness in the face, arms, or legs, usually affecting both sides of the body

    Signs and tests

    An examination may show:

    • Abnormal reflexes
    • Confusion
    • Involvement of all four arms and legs (spastic quadriplegia)
    • Weakness of the face, arms, and legs (upper motor neuron syndromes)

    A head MRI scan may reveal a problem in the brainstem (pons). This is the main diagnostic test.

    Other tests may include:

    • Blood sodium levels and other blood tests
    • Brainstem auditory evoked response (BAER)