Therapeutic challenges in the management of osmotic demyelination syndrome

<h3>Rationale</h3><p dir="ltr">There is an increasing and compelling need for early recognition of features of osmotic demyelination syndrome (ODS), and a further attempt at correcting this even where presentation is late.</p><h3>Patient concerns</h3><...

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Main Author: Mohamed Elshafei (9376832) (author)
Other Authors: Mohammed I. Danjuma (13569767) (author), Rania El Tahir (20318433) (author)
Published: 2020
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author Mohamed Elshafei (9376832)
author2 Mohammed I. Danjuma (13569767)
Rania El Tahir (20318433)
author2_role author
author
author_facet Mohamed Elshafei (9376832)
Mohammed I. Danjuma (13569767)
Rania El Tahir (20318433)
author_role author
dc.creator.none.fl_str_mv Mohamed Elshafei (9376832)
Mohammed I. Danjuma (13569767)
Rania El Tahir (20318433)
dc.date.none.fl_str_mv 2020-06-01T00:00:00Z
dc.identifier.none.fl_str_mv 10.1097/md.0000000000020283
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Therapeutic_challenges_in_the_management_of_osmotic_demyelination_syndrome/27896289
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Clinical sciences
Neurosciences
demyelination
hyponatremia
osmotic
dc.title.none.fl_str_mv Therapeutic challenges in the management of osmotic demyelination syndrome
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Rationale</h3><p dir="ltr">There is an increasing and compelling need for early recognition of features of osmotic demyelination syndrome (ODS), and a further attempt at correcting this even where presentation is late.</p><h3>Patient concerns</h3><p dir="ltr">A 49-year-old male admitted into the emergency department with a complaint of lethargy and severe hyponatremia, with subsequent ODS supervening on initial attempts at correction.</p><h3>Diagnosis</h3><p dir="ltr">Rapid rise in serum sodium concentration (121 mmol/L in 8 hours from a nadir of 101 mmol/L), concomitant deterioration in patient's conscious level support the diagnosis of ODS.</p><h3>Intervention</h3><p dir="ltr">Concomitant administration of 5% dextrose water with desmopressin with a therapeutic objective of gradual relowering of serum sodium concentration.</p><h3>Outcomes</h3><p dir="ltr">Significant improvement in patients’ conscious level and motor function with the commencement of sodium relowering therapy. The patient was eventually discharged home.</p><h3>Lessons</h3><p dir="ltr">Regardless of the temporal profile of neurologic sequelae following ODS due to hyponatremia, its worthwhile attempting initial sodium relowering with dextrose 5% and desmopressin and then monitoring of biochemical and neurologic markers.</p><h2>Other Information</h2><p dir="ltr">Published in: Medicine<br>License: <a href="http://creativecommons.org/licenses/by/4.0" target="_blank">http://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1097/md.0000000000020283" target="_blank">https://dx.doi.org/10.1097/md.0000000000020283</a></p>
eu_rights_str_mv openAccess
id Manara2_6465820b5e68c1715ff2d049f0123c59
identifier_str_mv 10.1097/md.0000000000020283
network_acronym_str Manara2
network_name_str Manara2
oai_identifier_str oai:figshare.com:article/27896289
publishDate 2020
repository.mail.fl_str_mv
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rights_invalid_str_mv CC BY 4.0
spelling Therapeutic challenges in the management of osmotic demyelination syndromeMohamed Elshafei (9376832)Mohammed I. Danjuma (13569767)Rania El Tahir (20318433)Biomedical and clinical sciencesClinical sciencesNeurosciencesdemyelinationhyponatremiaosmotic<h3>Rationale</h3><p dir="ltr">There is an increasing and compelling need for early recognition of features of osmotic demyelination syndrome (ODS), and a further attempt at correcting this even where presentation is late.</p><h3>Patient concerns</h3><p dir="ltr">A 49-year-old male admitted into the emergency department with a complaint of lethargy and severe hyponatremia, with subsequent ODS supervening on initial attempts at correction.</p><h3>Diagnosis</h3><p dir="ltr">Rapid rise in serum sodium concentration (121 mmol/L in 8 hours from a nadir of 101 mmol/L), concomitant deterioration in patient's conscious level support the diagnosis of ODS.</p><h3>Intervention</h3><p dir="ltr">Concomitant administration of 5% dextrose water with desmopressin with a therapeutic objective of gradual relowering of serum sodium concentration.</p><h3>Outcomes</h3><p dir="ltr">Significant improvement in patients’ conscious level and motor function with the commencement of sodium relowering therapy. The patient was eventually discharged home.</p><h3>Lessons</h3><p dir="ltr">Regardless of the temporal profile of neurologic sequelae following ODS due to hyponatremia, its worthwhile attempting initial sodium relowering with dextrose 5% and desmopressin and then monitoring of biochemical and neurologic markers.</p><h2>Other Information</h2><p dir="ltr">Published in: Medicine<br>License: <a href="http://creativecommons.org/licenses/by/4.0" target="_blank">http://creativecommons.org/licenses/by/4.0</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1097/md.0000000000020283" target="_blank">https://dx.doi.org/10.1097/md.0000000000020283</a></p>2020-06-01T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1097/md.0000000000020283https://figshare.com/articles/journal_contribution/Therapeutic_challenges_in_the_management_of_osmotic_demyelination_syndrome/27896289CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/278962892020-06-01T00:00:00Z
spellingShingle Therapeutic challenges in the management of osmotic demyelination syndrome
Mohamed Elshafei (9376832)
Biomedical and clinical sciences
Clinical sciences
Neurosciences
demyelination
hyponatremia
osmotic
status_str publishedVersion
title Therapeutic challenges in the management of osmotic demyelination syndrome
title_full Therapeutic challenges in the management of osmotic demyelination syndrome
title_fullStr Therapeutic challenges in the management of osmotic demyelination syndrome
title_full_unstemmed Therapeutic challenges in the management of osmotic demyelination syndrome
title_short Therapeutic challenges in the management of osmotic demyelination syndrome
title_sort Therapeutic challenges in the management of osmotic demyelination syndrome
topic Biomedical and clinical sciences
Clinical sciences
Neurosciences
demyelination
hyponatremia
osmotic