Abstract
We report a 28-year-old postpartum female with acute delirium, agitation, confusion, visual hallucinations, and limb weakness. Investigations revealed severe hypernatremia, hyperuricemia, rhabdomyolysis, acute kidney injury, normal serum and urine osmolarity, normal urine spot sodium level, and normal serum antidiuretic hormone level. Magnetic resonance imaging of brain revealed hyperintensities in bilateral corticospinal tracts showing the classical “Wine Glass sign” suggesting hypernatremia-related osmotic demyelination. Patient improved with gradual correction of hypernatremia. We would like to highlight the importance of timely recognition and appropriate treatment of this rare condition which is potentially fatal and may also lead to severe permanent neurological deficits.
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