Case report: Osmotic demyelination syndrome owing to rapid correction of hyperosmolar hyperglycaemia

Abstract

Osmotic demyelination syndrome (ODS) is a rare complication in hospitalised patients, most commonly associated with rapid correction of hyponatraemia. While being uncommon, it is a dangerous problem that could result in death or severe disability. It has been mostly associated with rapid correction of hyponatraemia. However, few reports have shown it in complicated diabetes mellitus, either during rapid correction of hyperglycaemia or at any time during the course of the disease. ODS is a non-inflammatory demyelination of neurons caused by oligodendrocyte apoptosis and macrophage infiltration which degrades myelin. ODS is divided into two categories: central pontine myelinolysis and extrapontine myelinolysis based on the site of demyelination. It is important to raise awareness of ODS among clinicians, particularly when correcting hyperglycaemia.