Q: Name at least five conditions seen in ICU - beside rapid correction of hyponatremia - which may cause Central pontine myelinolysis (CPM)?

Answer: Firstly, Central pontine myelinolysis (CPM) is a misnomer as it may occur outside the pons. Secondly, it is a demyelination process - and so the better term would be "osmotic demyelination syndrome". Thirdly, other disease processes seen in ICU, beside rapid correction of hyponatremia may also cause osmotic demyelination syndrome like

• in post liver transplant patients
• in patients with severe alcoholism or any disease process causing Wernicke encephalopathy due to malnutrition or electrolyte imbalance
• in patients with severe burns
• in AIDS patients
• in post hematopoietic stem cell transplantation patients