Central pontine myelinolysis sodium concentration. Three to five days later, a second phase of neurological manifestations occurs correlating with the onset of myelinolysis. Observable immediate precursors may include seizures, disturbed consciousness, gait changes, and decrease or cessation of respiratory function. The classical clinical presentation is the progressive development of spastic quadriparesis, pseudobulbar palsy, and emotional lability (pseudobulbar affect), with other more variable neurological features associated with brainstem damage. These result from a rapid myelinolysis of the corticobulbar and corticospinal tracts in the brainstem. The most common cause is overly rapid correction of low blood sodium levels (hyponatremia). Apart from rapid correction of hyponatraemia,
Department of Defense Serum Repository Department of Defense Serum Repository The Department of Defense Serum Repository (also referred to as the DoD Serum Repository or simply DoDSR) is a biological repository operated by the United States Department of Defense containing over 50,000,000 human serum specimens, collected primarily from applicants to and members of the United States Uniformed Services. The DoDSR is located in Silver Spring, Maryland and is operated by the Armed Forces Health Surveillance Center (AFHSC), a subordinate of the United States Army Center for Health Promotion and Preventive Medicine (USACHPPM), itself evolved from the Johns Hopkins School of Hygiene and Public Health. The