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Yadav SK, Ojha R, Parajuli N, Karki S, Pant S, Karn R, Gajurel BP, Rajbhandari R, Gautam N, Shrestha A, Jha A. Occurrence of osmotic demyelination syndrome in diabetes mellitus: A case report and literature review of various etiologies for osmotic demyelination syndrome. SAGE Open Med Case Rep 2022; 10:2050313X221135595. [PMID: 36337162 PMCID: PMC9630894 DOI: 10.1177/2050313x221135595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022] Open
Abstract
Osmotic demyelination syndrome is a rare condition reported mainly in the case of
rapid correction of hyponatremia, but it can occur even in the case of
complicated diabetes mellitus either during rapid correction of hyperglycemia or
anytime during the complicated diabetes mellitus. We report a case of
complicated diabetes mellitus developing osmotic demyelination syndrome. The
patient had presented with altered sensorium and seizure, which was initially
diagnosed as hyperglycemia, but during his treatment, the magnetic resonance
imaging of brain revealed central pontine myelinolysis. Our search on the causes
of osmotic demyelination syndrome other than rapid correction of hyponatremia
has revealed several other causes like autoimmune liver disease, Sjogren’s
syndrome and non-Hodgkin’s lymphoma in addition to diabetes mellitus.
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Affiliation(s)
- Sushil Kumar Yadav
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Rajeev Ojha
- Department of Neurology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Naresh Parajuli
- Department of Endocrinology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Susmin Karki
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Sobin Pant
- Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Ragesh Karn
- Department of Neurology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Bikram Prasad Gajurel
- Department of Neurology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Reema Rajbhandari
- Department of Neurology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Niraj Gautam
- Department of Neurology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Ashish Shrestha
- Department of Neurology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Anamika Jha
- Department of Radiology, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
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Abstract
Several conditions cause damage to the inherently normal myelin of central nervous system, perepheral nervous system or both central and perepheral nervous system and hence termed as central demyelinating diseases, perepheral demyelinating diseases and combined central and perepheral demyelinating diseases respectively. Here we analysed and foccused on the etiology, prevalance, incidence and age of these demyelinating disorders. Clinical attention and various diagnostic tests are needed to adequately assess all these possibilities.
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Affiliation(s)
- Man Mohan Mehndiratta
- Department of Neurology, Janakpuri Superspeciality Hospital, Janakpuri, New Delhi, India
| | - Natasha Singh Gulati
- Department of Pathology, Janakpuri Superspeciality Hospital, Janakpuri, New Delhi, India
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