A Case of Osmotic Demyelination Syndrome: Diagnostic and Therapeutic Challenges

Osmotic demyelination syndrome (ODS) is a rare anatomoclinical entity characterized by the destruction of myelin sheaths, most often secondary to very rapid correction of hyponatremia. Its clinical manifestations are highly variable, and its treatment is essentially based on prevention. We report here the case of ODS in a 54-year-old patient after correction of hyponatremia secondary to uncontrollable vomiting. The diagnosis of ODS was made by magnetic resonance imaging. The patient had more than one vulnerability factor that could explain the development of this syndrome. Even after restoration of fluid and electrolyte balance, she retained neuropsychiatric sequelae such as intermittent agitated confusion and ataxic gait.