Central Pontine Myelinolysis (CPM) is a serious medical condition associated with complications due to hyponatremia. Patients suffering from hyponatremia have an electrolyte imbalance resulting in an abnormally low sodium level. Although hyponatremia can be treated effectively if diagnosed early, if left undiagnosed, osmotic myelinolysis can occur—the demyelination of nerve fibers in the brain.
If you or a family member has suffered brain damage, serious injury, or death due to central pontine myelinolysis, contact our Houston medical malpractice lawyers. Call us today at (713) 658-0231 or fill out our simple online form to schedule your free consultation.
In most cases, the National Library of Medicine describes CPM results when doctors apply treatment too rapidly by giving patients fluids higher in salt to correct their electrolyte imbalance (hyponatremia). Because CPM usually occurs as a complication associated with treatment for other conditions, it’s often caused by negligence. At Hampton & King, we work with medical experts to identify failures in diagnosing and treating hyponatremia according to standard treatment protocols.
What Is Osmotic Demyelination Syndrome? (Negligent Sodium Correction)
Osmotic demyelination syndrome (ODS) is also referred to as central pontine myelinolysis (CPM). While they are very similar conditions, ODS is slightly different. It is a neurological disease that is caused when severe damage occurs to the myelin sheath of nerve cells located in the brainstem. Typically, the damage happens in the area of the brain known as the pons (CPM), however, it can also occur outside of the pons in ODS.
The condition can develop in patients who have suffered serious hyponatremia or conditions that result in decreased liver function.
Complications Associated with Central Pontine Myelinolysis
Hampton & King Houston catastrophic injury lawyers represent clients suffering from the following kinds of medical complications and injuries due to CPM:
- Cognitive impairment
- Brain damage
- Double vision
- Speech difficulty
- Confusion
- Muscle spasms
- Tremors
- Hallucinations
- Uncontrollable eye movements
Locked-In Syndrome as a Complication of Osmotic Demyelination Syndrome (ODS)
Locked-in syndrome (LIS) is one of the most devastating potential complications of ODS. It occurs when severe damage to the brainstem, particularly the pons, results in complete paralysis of voluntary muscles except for those controlling eye movements. Patients are fully conscious and aware but unable to move, speak, or communicate except through blinking or vertical eye movements.
How Does ODS lead to LIS?
- Damage to the Pons: In ODS, rapid sodium correction can cause demyelination in the brainstem, particularly the pons, which is responsible for motor control, sensory processing, and communication between the brain and body.
- Interruption of Neural Pathways: The damage disrupts the corticospinal and corticobulbar tracts, which control voluntary muscle movement. While cognitive and sensory functions remain intact, the patient loses nearly all ability to move or respond physically.
- Brainstem Integrity: Locked-in syndrome is a result of the preserved integrity of the brainstem’s reticular activating system (responsible for wakefulness and awareness) alongside paralysis of motor functions.
Symptoms of LIS
- Paralysis: Complete loss of voluntary motor function except for the eyes, with patients unable to move their limbs, trunk, or face.
- Eye Movements: Ability to communicate is limited to blinking or vertical eye movements, often used for yes/no responses or aided communication systems.
- Preserved Consciousness: Despite paralysis, patients retain full cognitive function, including awareness of their surroundings and internal thought processes.
Challenges for patients with LIS
- Communication Barriers: Patients require specialized assistive devices, such as eye-tracking systems, to communicate even basic needs.
- Emotional Distress: Being fully conscious but unable to interact with the world can lead to severe psychological challenges, including anxiety, depression, and feelings of isolation.
- Dependency: Patients with LIS require 24/7 care for feeding, hygiene, and medical monitoring.
- Risk of Secondary Complications: Prolonged immobility increases the risk of infections (e.g., pneumonia or urinary tract infections), pressure sores, and blood clots.
While some patients regain partial motor function with intensive therapy, full recovery is exceedingly rare in cases of locked-in syndrome caused by ODS. Care efforts for people with LIS often prioritize improving communication and addressing the patient’s emotional and psychological well-being.
Preventability of Locked-In Syndrome
Locked-in syndrome as a complication of ODS is preventable with proper medical care. Adhering to sodium correction guidelines and monitoring patients carefully during treatment for hyponatremia significantly reduces the risk. When negligent sodium correction causes ODS and locked-in syndrome, affected patients and their families may have grounds for a medical malpractice claim to seek justice and compensation for their immense suffering.
If you or a loved one has experienced locked-in syndrome due to ODS, consulting with a qualified attorney can help you explore your legal options and secure the resources needed for ongoing care and support.
Contributing Factors to Osmotic Demyelination Syndrome
Certain factors can significantly increase the risk of developing ODS during sodium correction. These factors make the brain more vulnerable to osmotic shifts, heightening the importance of careful and gradual treatment.
Patients with extremely low baseline sodium levels (e.g., <120 mmol/L) are at greater risk because their brains have undergone extensive osmotic adaptation. Rapid sodium correction in these cases can overwhelm the brain’s ability to maintain balance, leading to demyelination.
Certain Underlying Conditions That Increase Risk
- Liver Disease: Conditions such as cirrhosis impair the body’s ability to regulate electrolytes and increase vulnerability to osmotic damage.
- Malnutrition: A lack of essential nutrients weakens the brain’s resilience to shifts in sodium levels.
- Chronic Alcoholism: Prolonged alcohol abuse often results in both malnutrition and liver dysfunction, compounding the risk of ODS.
Concurrent Illnesses That Can Increase Risk
- Kidney Failure: Impaired kidney function disrupts electrolyte balance and complicates sodium correction efforts.
- Infections: Systemic infections or sepsis can exacerbate fluid and electrolyte imbalances.
- Metabolic Disorders: Conditions like diabetes or thyroid dysfunction can interfere with the body’s ability to adapt to sodium changes, increasing the likelihood of ODS.
Careful consideration of these contributing factors is crucial when managing sodium correction to minimize the risk of ODS. Healthcare providers must tailor their approach to account for these vulnerabilities and prevent avoidable harm.
Assessing Health Care Provider Negligence & CPM
Since CPM is usually a complication of treatment for hyponatremia, it is typically preventable. The question then arises, what did a doctor do—or fail to do—in treating a patient for low sodium? In most cases, hyponatremia is reversible when recognized and treated properly. In consultation with medical professionals, our legal team reviews patient records and results of lab tests in order to recreate the decisions and actions of a doctor. In doing so, we can often identify important information that was missed or ignored in failures to properly treat hyponatremia.
Assessing your care begins with sharing your story with a member of our staff. Our Medical Director, who is a full-time MD, will evaluate your case to understand what went wrong and why. She will consult with medical specialists who understand your case, and together our medical and legal professionals will begin to build your claim. Understanding the merits of your case is only the first step—but it’s one of the most vital when it comes to your success. Few law firms are as equipped as Hampton & King to address your unique situation.
Contact Our Dedicated ODS Attorneys Today
We understand the medical issues involved in CPM. If you or a family member has suffered from CPM due to physician negligence, contact a medical malpractice lawyer in Houston. Hartley Hampton and Christopher King are standing by to provide the assistance you need.
Start by requesting a free consultation—call us at (713) 658-0231.