DOI: 10.36347/sjams.2018.v06i04.055

Pages: 1648-1651

Osmotic demyelination syndrome (central pontine myelinolysis and extrapontine myelinolysis) is a rare condition. Although most frequently reported cause is the quick correction of hyponatremia, the osmotic demyelinating syndrome can be explained, from a physiological point of view, by two major groups of factors, specifically: factors related to under-nutrition or fasting, and factors related to the variation of osmolarity. In our case, the diagnosis of osmotic demyelination syndrome was suspected in front of both; the neurological signs (altered level of consciousness, Focal neurologic signs) and the careful correction of severe hyponatremia. The confirmation of the disorder was done by the encephalic MRI, as reported in the literature. Although occurred following a correction of severe hyponatremia, the most likely etiophysiological hypothesis was the combination of; the existence of the multiple pro-apoptotic risk factors, such as: under-nutrition, Diabetic ketoacidosis (DKA), renal failure, hypokalemia, depth of hyponatremia with minor contribution of the speed of correction of hyponatremia (considered slow and careful). The same risk factors have been reported in the literature.