A case of osmotic demyelination presenting with severe hypernatremia

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Abstract

Osmotic demyelination syndrome is a demyelinating disorder associated with rapid correction of hyponatremia. But, it rarely occurs in acute hypernatremia, and it leads to permanent neurologic symptoms and is associated with high mortality. A 44-year-old woman treated with alternative medicine was admitted with a history of drowsy mental status. Severe hypernatremia (197 mEq/L) with hyperosmolality (415 mOsm/kgH2O) was evident initially and magnetic resonance imaging revealed a high signal intensity lesion in the pons, consistent with central pontine myelinolysis. She was treated with 0.45% saline and 5% dextrose water and intravenous corticosteroids. Serum sodium normalized and her clinical course gradually improved. Brain lesion of myelinolysis also improved in a follow-up imaging study. This is the first report of a successful treatment of hypernatremia caused by iatrogenic salt intake, and it confirms the importance of adequate fluid supplementation in severe hypernatremia.

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APA

Han, M. J., Kim, D. H., Kim, Y. H., Yang, I. M., Park, J. H., & Hong, M. K. (2015, June 1). A case of osmotic demyelination presenting with severe hypernatremia. Electrolyte and Blood Pressure. Korean Society of Electrolyte and Blood Pressure Research. https://doi.org/10.5049/EBP.2015.13.1.30

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