Central pontine myelinolysis: a complication of hyponatremia or of therapeutic intervention?
Haibach, H.; Ansbacher, L.E.; Dix, J.D.
Journal of Forensic Sciences 32(2): 444-451
1987
ISSN/ISBN: 0022-1198 PMID: 3572337 Document Number: 296888
We report four cases of central pontine myelinolysis (CPM) that illustrate important features of the disorder. The condition is described mainly in the neurological literature and, to our knowledge, is not discussed in the forensic science journals. This disorder must be recognized and understood by the forensic science expert who addresses issues of liability. In cases of multiple motor deficits and death with a history of hyponatremia, CPM must be included in the differential diagnosis. Careful examination of the pons and adjoining structures must be performed. Myelin stains are advisable. The association of CPM with major illnesses, hyponatremia and the correction of hyponatremia by intravenous saline infusions is discussed.