Central and Extrapontine Myelinolysis in the Setting of Hyperglycemia.

Abstract

Osmotic demyelination syndrome (ODS) was first described by Adams et al. in 1959 as a combination of quadriparesis, pseudobulbar paralysis, and the distinctive myelin loss in the pons, attributable to alcoholism or malnutrition.[1] ODS has since been commonly attributed to rapid correction of chronic hyponatremia. Other reported etiologies include alcohol withdrawal, liver transplantation, hypokalemia, hypernatremia as well as severe hyperglycemia. [2-6] (e1-20) Here, we describe a case of ODS associated with diabetic ketoacidosis (DKA) and review the existing literature on hyperglycemia-related ODS.