Osmotic demyelination syndrome results from overly rapid serum sodium correction and is often iatrogenic. We report a 50-year-old hypertensive woman on Indapamide presenting with malaise, dizziness and serum sodium less than 100mmol/l who developed osmotic demyelination syndrome after correction of the hyponatremia. Good neurological recovery was seen after plasmapheresis.

Dengue fever is one of the commonest tropical disease in the tropics. It can present with mild acute febrile illness to severe organ failure. Reported neurological complications of dengue include dengue encephalopathy, encephalitis, transverse myelitis and intracranial haemorrhage. Intracranial haemorrhage in dengue can present as subdural haematoma, extradural haematoma, intracerebral haemorrhage and subarachnoid haemorrhage. We report here a case of subarachnoid haemorrhage in a patient with severe dengue. Our patient was a 30-year-old man who presented with acute febrile illness. He subsequently developed plasma leakage and upper gastrointestinal bleeding. He then had reduced conscious level. Computed tomography of his brain showed subarachnoid haemorrhage. He eventually succumbed to his illness.