International Journal of Biomedicine. 2018;8(3):250-252.
Originally published September 15, 2018
Osmotic demyelination syndrome (ODS) has been described in end-stage renal disease patients recently started on hemodialysis and is usually attributed to a rapid correction of hyponatremia. We describe a case of ODS developing after recent hemodialysis and unrelated to serum sodium changes. Our aim is to help provide more data about the pathophysiology and precipitating factors of this syndrome. ODS is seen in the setting of acute osmotic changes, which has been historically linked to sodium levels. We hope that our clinical case highlights the other possible contributing factors leading to this syndrome and will aid in proper avoidance and suitable management of this condition.
- Tarhan NC, Agildere AM, Benli US, Ozdemir FN, Aytekin C, Can U. Osmotic demyelination syndrome in end-stage renal disease after recent hemodialysis: MRI of the brain. AJR Am J. Roentgenol. 2004;182(3):809-16.
- Ravindran T, Paneerselvam, Radha, Yabesh TA. Osmotic Demyelination Syndrome Presenting with Chorea. J Assoc Physicians India. 2006;64(4):89-90. PubMed
- Adams RD, Victor M, Mancall EL. Central pontine myelinolysis: a hitherto undescribed disease occurring in alcoholic and malnourished patients. AMA Arch Neurol Psychiatry. 1959;81(2):154–72. PubMed
- Gupta N, Ahmad M, Fatima J, Karoli R, Ahmad A. Osmotic Demyelination Syndrome in a Eunatremic Patient with Chronic Kidney Disease. J Assoc Physicians India. 2017;65(3):98-99. PubMed
- Verbalis JG, Gullans SR. Rapid correction of hyponatremia produces differential effects on brain osmolyte and electrolyte reaccumulation in rats. Brain Res. 1993;606(1):19-27. PubMed
- Jha AA, Behera V, Jairam A, Baliga KV. Osmotic demyelination syndrome in a normonatremic patient of chronic kidney disease. Indian J Crit Care Med. 2014;18(9):609-11. doi: 10.4103/0972-5229.140153. PubMed
- Endo Y, Oda M, Hara M. Central pontine myelinolysis. Acta Neuropathol. 1981;53(2):145-153. PubMed
- Moritz ML, Ayus JC. The pathophysiology and treatment of hyponatraemic encephalopathy: an update. Nephrol Dial Transplant. 2003;18(12):2486-91. PubMed
Received June 16, 2018.
Accepted September 4, 2018.
©2018 International Medical Research and Development Corporation.