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- Title
Osmotic demyelination syndrome: a potentially avoidable disaster.
- Authors
S.-H. Lin; Y.-J. Hsu; J.-S. Chiu; S.-J. Chu; M.R. Davids; M.L. Halperin
- Abstract
Osmotic demyelination of the brain (ODS) is a dreaded complication that typically occurs several days after aggressive therapy for chronic hyponatraemia, but is eminently avoidable. In this teaching exercise, Professor McCance, an imaginary consultant, is asked to explain how he would have treated a 28-year-old female who had hyperkalaemia, hypoglycaemia, hypotension and hyponatraemia (118 mM) to prevent the development of ODS. He begins with a review of the physiology, including his own landmark work on chronic hyponatraemia associated with a contracted extracellular fluid volume. Adding quantitative analysis, the cause of the excessive rise in plasma sodium concentration is revealed, and a better plan for therapy is proposed.
- Subjects
DEMYELINATION; BRAIN; THERAPEUTIC complications; HYPONATREMIA
- Publication
QJM: An International Journal of Medicine, 2003, Vol 96, Issue 12, p935
- ISSN
1460-2725
- Publication type
Article
- DOI
10.1093/qjmed/hcg159