Isolated Extrapontine Myelinolysis: A Rare Consequence of Rapid Correction of Acute Hyponatremia

Abstract

Rapid correction of hyponatremia may lead to rare (incidence of 0.4% to 0.56% among neurological patients) and devastating complication of osmotic demyelination syndrome (ODS). Isolated Extrapontine Myelinolysis (EPM) is relatively uncommon among ODS patients with variable presentation. A 53-yearold female developed altered sensorium after gastroenteritis and rapid sodium correction. An MRI performed showed EPM in bilateral putamen, ventrolateral thalami and middle cerebellar peduncles. Despite supportive care, including sodium readjustment and mechanical ventilation, she succumbed after three weeks. This case underscores the importance of early recognition and management of EPM, as timely intervention may improve prognosis.

Keywords

• Osmotic Demyelination Syndrome (ODS)
• Extraopontine Demyelination (EPM)
• Hyponatremia
• Rapid Correction