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. 2015 Mar;19(3):166-9.
doi: 10.4103/0972-5229.152760.

Osmotic demyelination syndrome in Intensive Care Unit

Parnandi Bhaskar Rao  1 , Afzal Azim  2 , Neha Singh  3 , Arvind Kumar Baronia  2 , Anand Kumar  2 , Banani Poddar  2
Affiliations

Osmotic demyelination syndrome in Intensive Care Unit

Parnandi Bhaskar Rao et al. Indian J Crit Care Med. 2015 Mar.

Abstract

Dyselectrolytemia, especially hyponatremia is a common occurrence in hospitalized patients, and a number of dreaded complications arise out of the disorder itself and its treatment. Osmotic demyelination syndrome develops secondary to rapid correction of hyponatremia. As the disease is rare and available literature from Intensive Care Units are limited, we report our retrospective observation over 5 years. Overall incidence was 2.5% with altered sensorium and hypokalemia as most common symptom and associated factor respectively. Isolated pontine involvement was in 41% and combined pontine, and extra-pontine lesions were found in 23% of cases. All patients received supportive therapy; out of which 2 died and complete neurological recovery was seen in 24% of patients. Our findings suggest that a well organized supportive therapy and multidisciplinary approach is of more concern than many available therapeutic modalities which are still to be proved.

Keywords: Demyelination; Intensive Care Unit; hyponatremia; osmotic; syndrome.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
T2-weighted magnetic resonance imaging showing areas of demyelination in bilateral basal ganglia and thalami, known as extra-pontine myelinolysis
Figure 2
Figure 2
T2-weighted magnetic resonance imaging showing symmetrical hyperintensity of midbrain and pons suggestive of both pontine and extra pontine myelinolysis
See this image and copyright information in PMC

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