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Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults
Published on: November 7, 2014
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A 47-year-old alcoholic man with progressive abnormal gait.
1Department of General Internal Medicine, The Cleveland Clinic Foundation, Ohio 44195, USA.
Cleveland Clinic Journal of Medicine
|November 15, 2002
Summary
Central pontine myelinolysis (CPM) is a neurological condition to consider in patients with alcoholism and malnutrition presenting with ataxia. Early diagnosis is crucial as outcomes vary and are difficult to predict.
Area of Science:
- Neurology
- Radiology
Background:
- Central pontine myelinolysis (CPM) is a demyelinating disease affecting the pons.
- It is often associated with rapid correction of hyponatremia, but can occur in other clinical settings.
Observation:
- Patients with a history of alcoholism and malnutrition presenting with ataxia should be evaluated for CPM.
- Neurological symptoms like ataxia can manifest irrespective of serum sodium levels.
Findings:
- T2-weighted MRI sequences are the most sensitive for detecting CPM.
- Radiological changes may be delayed for weeks after the initial insult.
- The causative insult may not always be apparent.
Implications:
- Early consideration of CPM in the differential diagnosis is vital for appropriate patient management.
- Supportive care is essential to prevent complications.
- Currently, no specific treatment effectively reverses CPM, and patient outcomes are variable and unpredictable.
