Complete Neurological Recovery in Two Cases of Osmotic Demyelination Syndrome Following Rapid Correction of Chronic Hyponatremia.
- Author:
Eun Young KIM
1
;
Joo Hark YI
;
Useok NOH
;
Sang Woong HAN
;
Kyu Yong LEE
;
Ho Jung KIM
Author Information
1. Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea. cardion@hanyang.ac.kr
- Publication Type:Case Report
- Keywords:
Central pontine myelinolysis;
Extrapontine myelinolysis;
Hyponatremia;
Magnetic Resonance Imaging
- MeSH:
Brain;
Deglutition Disorders;
Demyelinating Diseases*;
Dysarthria;
Female;
Humans;
Hyponatremia*;
Magnetic Resonance Imaging;
Middle Aged;
Myelinolysis, Central Pontine;
Pons;
Potassium;
Sleep Stages;
Sodium;
Stupor;
Survivors
- From:Korean Journal of Nephrology
2007;26(3):342-347
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The osmotic demyelination syndrome (ODS) is a distinctive clinical entity with characteristic MR features in the central pons (central pontine myelinolysis, CPM) and other locations (extrapotine myelinolysis, EPM). ODS is mainly seen following rapid correction of the serum sodium level in hyponatremic patients. In the past, ODS used to be considered as fatal. However, some recent reports have described cases of survival from this syndrome, but most survivors seem to suffer irreversible neurological deficits. We report one case of 46-year-old woman who developed stupor at day 7 and the other case of 56-year-old woman with drowsiness, dysarthria and dysphagia at day 3 following the correction of hyponatremia. In both cases, the serum potassium levels were low at the time of presentation with hyponatremia. By means of brain MRI, the first case was diagnosed as CPM with EMP and the second case as isolated EPM. With conservative treatments, complete neurological recovery was achieved at 4-6 weeks after onset of ODS.
