Extrapontine myelinolysis (EPM) is one of the complications occurring secondary to rapid correction of hyponatremia, and is, along with central pontine myelinolysis encompassed by the more recent term osmotic demyelination syndrome.
In the vast majority of cases it is associated with central pontine myelinolysis but it can also (rarely) occur as an isolated entity.
In extrapontine myelinolysis, sites of involvement include:
- 1. Martin RJ. Central pontine and extrapontine myelinolysis: the osmotic demyelination syndromes. J. Neurol. Neurosurg. Psychiatr. 2004;75 Suppl 3 (suppl 3): iii22-8. doi:10.1136/jnnp.2004.045906 - Free text at pubmed - Pubmed citation
- 2. Huin E, Tan KP. CT and MR findings in central pontine and extrapontine myelinolysis-a study of two patients. Singapore Med J. 1997;37 (6): 622-6. Pubmed citation
- 3. Brown WD, Caruso JM. Extrapontine myelinolysis with involvement of the hippocampus in three children with severe hypernatremia. J. Child Neurol. 1999;14 (7): 428-33. Pubmed citation
- 4. Aralikatte O Saroja, Karkal R Naik, Rajendra V Mali, Sanjeeva R Kunam. 'Wine Glass' sign in recurrent postpartum hypernatremic osmotic cerebral demyelination. (2013) Annals of Indian Academy of Neurology. 16 (1): 106. doi:10.4103/0972-2327.107719 - Pubmed
- 5. Biller, Jose, Hornik, Alejandro, Rodriguez-Porcel, Federico, Agha, Caroline, Flaster, Murray, Morales Vidal, Sarkis Gibran, Schneck, Michael J, Lee, John. Central and Extrapontine Myelinolysis Affecting the Brain and Spinal Cord. An Unusual Presentation of Pancreatic Encephalopathy. (2018) Frontiers in Neurology. 3: 135. doi:10.3389/fneur.2012.00135 - Pubmed