Die Pontine Myelinolyse - Eine gravierende Therapiefolge?

The cerebral pontine myelinolysis is a very rare lesion, primarily described by Adams in 1959 [1]. It is suspected to be caused by rapid correction of hyponatremia. The following two case reports demonstrate the different causes of hyponatremia and, additionally suggest that rapid correction of sodium plasma-concentration is not the only mechanism by which pontine myelinolysis occurs. To avoid pontine myelinolysis and to treat hyponatremia correctly, it seems to be very important to keep in mind the different causes of hyponatremia - the cerebral salt wasting syndrome (CSWS) [2] or the syndrome of inadequate ADH secretion (SIADH) [3] - and their different therapies. The chronicity of hyponatremia and the rate of sodium correction are decisive for the neurological outcome. Therefore, the rate of sodium correction should not exceed 12 mmol/l per day.