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Osmotic Demyelination Syndrome: A Rare Clinical Image
Version 1
: Received: 31 August 2023 / Approved: 4 September 2023 / Online: 5 September 2023 (03:59:35 CEST)
A peer-reviewed article of this Preprint also exists.
Koul, P.; Harjpal, P.; Raghumahanti, R. Osmotic Demyelination Syndrome: A Rare Clinical Image. Diagnostics 2023, 13, 3393. Koul, P.; Harjpal, P.; Raghumahanti, R. Osmotic Demyelination Syndrome: A Rare Clinical Image. Diagnostics 2023, 13, 3393.
Abstract
The term "Osmotic Demyelination Syndrome" (ODS) is synonymous with central pontine myelinolysis (CPM), denoting a condition characterized by brain damage, particularly affecting the white matter tracts of the pontine region. This damage arises due to rapid correction of metabolic imbalances, primarily cases of hyponatremia. Noteworthy triggers encompass severe burns, liver transplantations, anorexia nervosa, hyperemesis gravidarum, and hyperglycaemia, all linked to the development of CPM. Clinical manifestations encompass a spectrum of signs and symptoms, including dysphagia, dysarthria, spastic quadriparesis, pseudobulbar paralysis, ataxia, lethargy, tremors, disorientation, catatonia, and, in severe instances, locked-in syndrome and coma. A recent case involving a 45-year-old woman illustrates these complexities. Upon admission to the Medicine Intensive Care Unit, she presented with symptoms indicative of diminished responsiveness and bilateral weakness in upper and lower limbs. Of significance, the patient had a pre-existing medical history of hyperthyroidism. Extensive diagnostic investigations were undertaken, revealing compelling evidence of profound hyponatremia through blood analyses. Furthermore, magnetic resonance imaging (MRI) was performed, unveiling conspicuous areas of abnormal hyperintensity located in the central pons, intriguingly accompanied by spared peripheral regions. These radiological findings align with the characteristic pattern associated with osmotic demyelination syndrome, illuminating the underlying pathology.
Keywords
osmotic demyelination syndrome (OSD); hyponatremia; pons; hyperglycaemia
Subject
Public Health and Healthcare, Physical Therapy, Sports Therapy and Rehabilitation
Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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