Critical Insights Of Central Pontine Myelinolysis: Development Of Hypothetical Co-Relation With Hyperparathyroidism, Its Comorbidity

Abstract

Central Pontine Myelinolysis (CPM) is severe demyelinating disorder traditionally linked to rapid correction of hyponatremia. Recent insights recommend as metabolic and endocrine disturbances may also contribute to its development. This review explores the established comorbidities of CPM — including alcoholism, liver disease, and electrolyte imbalances and proposes a hypothetical correlation with hyperparathyroidism. We suggest that CNS injury-induced stress may elevate cortisol levels, disrupting calcium-phosphate balance and stimulating parathyroid hormone (PTH) secretion. This neuroendocrine-inflammatory cascade could exacerbate osmotic stress on pontine tissue and increased secretion of parathyroid hormone increasing the risk of demyelination and hyperparathyroidsm. Understanding this possible link emphasizes the need for broader metabolic monitoring in patients vulnerable to CPM along with hyperparathyrodism. Further studies are warranted to validate this novel hypothesis and to redefine the systemic approach toward CPM prevention and management.