Central pontine myelinolysis
ICD-10 G37.2 is a billable code used to indicate a diagnosis of central pontine myelinolysis.
Central pontine myelinolysis (CPM) is a neurological disorder characterized by the demyelination of the central pons, typically resulting from rapid correction of hyponatremia (low sodium levels). This condition is often seen in patients with a history of chronic alcoholism, malnutrition, or those undergoing aggressive treatment for electrolyte imbalances. Clinically, CPM presents with a range of symptoms including dysarthria, dysphagia, quadriparesis, and altered consciousness. The pathophysiology involves the disruption of oligodendrocytes, which are responsible for myelin production in the central nervous system. CPM is often associated with other demyelinating diseases, such as multiple sclerosis (MS), where the immune system mistakenly attacks the myelin sheath. Treatment focuses on supportive care and addressing the underlying causes, such as correcting electrolyte imbalances slowly to prevent further demyelination. Immunomodulatory treatments, commonly used in MS, may not be directly applicable to CPM but are crucial in managing demyelinating diseases overall. Accurate diagnosis and coding are essential for appropriate management and reimbursement.
Detailed neurological examination findings, imaging results, and electrolyte levels.
Patients presenting with acute neurological deficits after rapid correction of hyponatremia.
Ensure that the cause of hyponatremia is documented to support the diagnosis of CPM.
Comprehensive history of electrolyte management and any underlying conditions.
Patients with chronic conditions leading to electrolyte imbalances, such as liver disease or renal failure.
Document the timeline of sodium correction to establish causality with CPM.
Used to rule out other causes of neurological symptoms.
Document indications for imaging and findings.
Neurology specialists should ensure imaging correlates with clinical findings.
Common symptoms include dysarthria, dysphagia, quadriparesis, and altered consciousness, often following rapid correction of hyponatremia.
