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Therapeutic challenges in the management of osmotic demyelination syndrome: A case report of a favorable outcome from a tertiary center
RATIONALE: There is an increasing and compelling need for early recognition of features of osmotic demyelination syndrome (ODS), and a further attempt at correcting this even where presentation is late. PATIENT CONCERNS: A 49-year-old male admitted into the emergency department with a complaint of l...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302644/ https://www.ncbi.nlm.nih.gov/pubmed/32541452 http://dx.doi.org/10.1097/MD.0000000000020283 |
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author | Elshafei, Mohamed Danjuma, Mohammed I. Tahir, Rania El |
author_facet | Elshafei, Mohamed Danjuma, Mohammed I. Tahir, Rania El |
author_sort | Elshafei, Mohamed |
collection | PubMed |
description | RATIONALE: There is an increasing and compelling need for early recognition of features of osmotic demyelination syndrome (ODS), and a further attempt at correcting this even where presentation is late. PATIENT CONCERNS: A 49-year-old male admitted into the emergency department with a complaint of lethargy and severe hyponatremia, with subsequent ODS supervening on initial attempts at correction. DIAGNOSIS: Rapid rise in serum sodium concentration (121 mmol/L in 8 hours from a nadir of 101 mmol/L), concomitant deterioration in patient's conscious level support the diagnosis of ODS. INTERVENTION: Concomitant administration of 5% dextrose water with desmopressin with a therapeutic objective of gradual relowering of serum sodium concentration. OUTCOMES: Significant improvement in patients’ conscious level and motor function with the commencement of sodium relowering therapy. The patient was eventually discharged home. LESSONS: Regardless of the temporal profile of neurologic sequelae following ODS due to hyponatremia, its worthwhile attempting initial sodium relowering with dextrose 5% and desmopressin and then monitoring of biochemical and neurologic markers. |
format | Online Article Text |
id | pubmed-7302644 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-73026442020-06-29 Therapeutic challenges in the management of osmotic demyelination syndrome: A case report of a favorable outcome from a tertiary center Elshafei, Mohamed Danjuma, Mohammed I. Tahir, Rania El Medicine (Baltimore) 4300 RATIONALE: There is an increasing and compelling need for early recognition of features of osmotic demyelination syndrome (ODS), and a further attempt at correcting this even where presentation is late. PATIENT CONCERNS: A 49-year-old male admitted into the emergency department with a complaint of lethargy and severe hyponatremia, with subsequent ODS supervening on initial attempts at correction. DIAGNOSIS: Rapid rise in serum sodium concentration (121 mmol/L in 8 hours from a nadir of 101 mmol/L), concomitant deterioration in patient's conscious level support the diagnosis of ODS. INTERVENTION: Concomitant administration of 5% dextrose water with desmopressin with a therapeutic objective of gradual relowering of serum sodium concentration. OUTCOMES: Significant improvement in patients’ conscious level and motor function with the commencement of sodium relowering therapy. The patient was eventually discharged home. LESSONS: Regardless of the temporal profile of neurologic sequelae following ODS due to hyponatremia, its worthwhile attempting initial sodium relowering with dextrose 5% and desmopressin and then monitoring of biochemical and neurologic markers. Wolters Kluwer Health 2020-06-12 /pmc/articles/PMC7302644/ /pubmed/32541452 http://dx.doi.org/10.1097/MD.0000000000020283 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 |
spellingShingle | 4300 Elshafei, Mohamed Danjuma, Mohammed I. Tahir, Rania El Therapeutic challenges in the management of osmotic demyelination syndrome: A case report of a favorable outcome from a tertiary center |
title | Therapeutic challenges in the management of osmotic demyelination syndrome: A case report of a favorable outcome from a tertiary center |
title_full | Therapeutic challenges in the management of osmotic demyelination syndrome: A case report of a favorable outcome from a tertiary center |
title_fullStr | Therapeutic challenges in the management of osmotic demyelination syndrome: A case report of a favorable outcome from a tertiary center |
title_full_unstemmed | Therapeutic challenges in the management of osmotic demyelination syndrome: A case report of a favorable outcome from a tertiary center |
title_short | Therapeutic challenges in the management of osmotic demyelination syndrome: A case report of a favorable outcome from a tertiary center |
title_sort | therapeutic challenges in the management of osmotic demyelination syndrome: a case report of a favorable outcome from a tertiary center |
topic | 4300 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302644/ https://www.ncbi.nlm.nih.gov/pubmed/32541452 http://dx.doi.org/10.1097/MD.0000000000020283 |
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