Effective treatment of osmotic demyelination syndrome with corticosteroid therapy: A case report

Abstract

Background: Osmotic demyelination syndrome (ODS) is characterized by widespread degeneration of myelin within the central nervous system (CNS) and has no established treatment. A limited number of cases have reported positive outcomes with corticosteroid in the treatment of ODS. We report the case of complete recovery of ODS with corticosteroid. Case presentation: A 48-year-old man presented with a stupor condition and exhausted. He was hospitalized at the Endocrinology Department with hyponatraemia, which was rapidly corrected with hypertonic saline from 103 to 116mmol/L. He was transferred to the Stroke Department because of worsening consciousness, arising rigidity and bradykinesia of the extremyties, worsening dysarthria and bradyphrenia. A brain magnetic resonance imaging (MRI) scan revealed later on pontine myelinolysis. He was commenced on corticoid 11 days after rapid correction of sodium. His status began to improve gradually after 10 days from starting of corticosteroid therapy and at 44 day-follow-up had no neurological deficit. Conclusion: Corticosteroid therapy can be considered as an effective treatment modality in osmotic demyelination syndrome.