Osmotic demyelination syndrome: pontine and extrapontine involvment

Discussion:

On viewing the imaging findings, history of recent treatment was looked into. Hyponatremia at time of admission was 104 mEq, corrected to 121 mEq within 24hrs. 

In the background of such a history with normal MRA, a diagnosis of central pontine myelinolysis with extra pontine myelinolysis involving bilateral basal ganglia was made. These conditions are now grouped under the term osmotic demyelination syndrome

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