Extrapontine myelinolysis in severe hypernatremia despite controlled sodium correction: a case report

Srishti Katiyar; Rajat Saha

doi:10.18203/2320-6012.ijrms20263566

Authors

Srishti Katiyar Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India
Rajat Saha Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, New Delhi, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20263566

Keywords:

Electrolyte disturbances, Extrapontine myelinosis, Hypernatremia, Neurology, Critical care, Osmotic demyelination syndrome

Abstract

Osmotic demyelination syndrome (ODS) is a condition characterized by sudden loss of myelin, typically triggered by rapid shifts in the body's osmotic balance. We report a 53-year-old male with recurrent carcinoma of the buccal mucosa who developed severe hypernatremia following sodium bicarbonate infusion. Despite careful and gradual correction of his elevated sodium levels, he subsequently developed quadriparesis, and MRI confirmed extrapontine myelinolysis. Supportive neurological, oncological, and hematological care was provided, but the patient ultimately succumbed to his illness. This case highlights that even cautious correction of sodium disturbances can precipitate ODS, particularly in patients with malignancy and metabolic stress, emphasizing the need for vigilant monitoring and individualized management.

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